New QAP Application
This form is used to collect information about potential new Qualifying Assessment Programs to provide International Mediation Institute Certification. You will have the option to send a link to yourself to finish completing this form later, so please ensure you insert the correct email address below.

All information on this first page must be completed before you can move on in the application. Please see our website at www.imimediation.org for information and guidance.

Email address *
Your organisation's full legal name *
In what year was your organisation formed, and under the laws of what country? *
Your organisation's contact details *
Include the address of your primary office, the organisation's phone number, email address, fax number, and website address if applicable.
Details of the person completing this questionnaire *
Include your name and title/position and telephone number.
What kind of IMI certification do you intend on providing? *
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