From:	Gerald P. Lepp, Administrator, Alternative Dispute Resolution Department

Date:	November 8, 2010

Re:	Arbitrator Applications

Applications for Arbitrator Certification can be Submitted After January 1, 2011

The ADR Department will accept applications for the arbitration panel, starting January 1, 2011. Moving forward, the Arbitration Panel will consist of seventy-five members. Through the recent recertification process, the ADR Department recertified fifty-two arbitrators, so spaces are limited.

Recertification Requirements

Requirements for Arbitration appointments are stated in Local Rule 83.10.

Successful completion of at least eight hours of training as an Arbitrator by a recognized Alternative Dispute Resolution organization, university, bar association, or Court is a pre-
requisite. In your application be sure to state (1) the name of the course, (2) description of the course, (3) date of completion, (4) ADR Oganization, (5) location of the training and (6) number of hours completed.

The Eastern District of New York does not currently provide any arbitration training.

Alternatively, actual experience as an Arbitrator and hearings held in at least three cases will satisfy the training requirement. In your application, state (1) the name of the case, (2) the Court or ADR Organization, (3) date(s) of the hearing(s), and (4) the location of the arbitration.

Applicants may be interviewed in person

Please fill out the attached application form and return it to the ADR Department for review after January 1, 2011.

APPLICATION FOR CERTIFICATION AS AN ARBITRATOR

U.S. DISTRICT COURT - EASTERN DISTRICT OF NEW YORK

(November 8, 2010)

Please file in triplicate.

1)	Applicant's Full Name: __________________________

Office contact information

Address: ______________________________________

______________________________________

Tel.:	_______________________

Mobile: _______________________

Fax:	_______________________

Email: _______________________

Home contact information

Address: ______________________________________

______________________________________

Tel.:	_______________________

Mobile: _______________________

Fax:	_______________________

2)	Date admitted to practice before:

A)	Appellate Division of the Supreme Court

of the State of New York . . . . . .	( / / ) (mm/dd/yyyy)

Appellate Department . . . .	____________

B)	United States District Court

Eastern District of New York . . . .	(____/___/____)

3)	Date admitted to practice before the highest court of a State:

(other than New York)

Court: Date of Admission: (____/___/____)

4) Bar Code:

(First initial, first and last name, last four digits social security number).

5)	Briefly list in chronological order, with dates, professional affiliations since admission to the Bar, or attach a copy of your professional resume.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

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6)	Are you presently engaged in the active practice of law in the Eastern District of New
York?

YES	NO	Formerly, (last year)_____/_______

7)	Check the fields of concentration of your present practice (not more than 4).

1. ___ Admiralty Law

2. ___ Attorney Fee Dispute

3. ___ Banking

4.	___ Consumer Law

5.	___ Construction Law

6.	___ Contract Interpretation

7.	___ Contract Law

8.	___ Copyright & Literary

9.	___ Corporation Law

10.	___ Entertainment

11.	___ Environmental Law

12.	___ ERISA

13.	___ Health Law

14.	___ Immigration

15.	___ Insurance Law

16.	___ International Law

17.	___ Labor Law

18.	___ Media

19.	___ Medical Malpractice

20.	___ Municipal Government

21.	___ Patent Law

22.	___ Pension Funds

23.	___ Personal Injury

24.	___ Product Liability Law

25.	___ Real Property Law

26.	___ RICO Act Law

27.	___ Secured Creditors

28.	___ Sports

29.	___ Tax

30.	___ Technology - Intellectual
Property

31.	___ Tort Law

32.	___ Trademark Law

33. ___ Trade Regulation Law

34. ___ Trade Secret Law

35. ___ Unfair Competition

36. ___ Other (please specify)

8)	State the percentage of your practice consists of representing defendants:	____

State the percentage of your practice consists of representing plaintiffs:	____

9)	Please list any district judge or magistrate judge in this district before whom you have appeared or who otherwise may have knowledge of your qualifications.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

10)	If you have not named any judicial officer of this Court in answer to question number 9, please list any other federal judges or state judges before whom you have appeared or who may otherwise have knowledge of your qualifications.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

11)	Have you ever been disciplined by any Court or Administrative Office of Court? If "Yes", please explain the circumstances:	Yes ___ No ___

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

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12)	Requirements for Arbitrator appointments are stated in Local Rule 83.10. The following questions are aimed at determining whether the applicant meets the requirements for appointment.

A)	Successful completion of at least eight hours of training as an Arbitrator by a
recognized Alternative Dispute Resolution organization, university, bar association, or	Court is a pre-requisite for recertification.

Have you received training as an arbitrator? Yes ___ No ___

If so, name of training organization, date of training, and briefly describe the course or program and the number of course hours.

Training Organization: ______________________________

Date of Completion: (___/____/____)

Number of Hours:	____________

Brief Description:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

B)	As an alternative to the eight hours of training, actual experience serving as an arbitrator
and conducting hearings in at least three cases will be considered. However, sitting in
small claims court or serving as an administrative judge will not be considered as
equivalent experience.

Have you served as a member of the EDNY Arbitration Panel?	Yes ___ No ___

If Yes, have you sat as an Arbitrator in at least three cases?	Yes ___ No ___

If Yes, list names of cases and approximate dates EDNY arbitration was conducted by applicant:

Case 1: _________________________________	Approx. Date: (___/____/____)

Case 2: _________________________________	Approx. Date: (___/____/____)

Case 3: _________________________________	Approx. Date: (___/____/____)

C)	The three case requirement may be fulfilled by arbitrating three cases as a member of a
recognized alternative dispute resolution organization such as The American Arbitration
Association, JAMS, FINRA, etc.

Are you currently a member of any other Arbitration Panel? Yes ___ No ___

If yes, state name of organization and list case names and approximate dates arbitration sessions were conducted by applicant:

Organization: ____________________________

Case 1: _________________________________	Approx. Date: (___/____/____)

Case 2: _________________________________	Approx. Date: (___/____/____)

Case 3: _________________________________	Approx. Date: (___/____/____)

D)	Please set forth any additional information you believe would bear upon your
qualifications to serve as an arbitrator. Attach additional pages if necessary.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

14)	Would you be willing to hear cases in (Feel free to check more than one location.):

Brooklyn ___ Central Islip ___ Manhattan ___ Own Office ___

15)	Would you be willing to serve on short notice, in the rare event where, for some reason, the arbitrator originally appointed is not available?

Yes ___ No ___

16) Do you understand the compensation limitations for arbitrators appointed and do

you agree to accept as full compensation payments within those limits?

Yes ___ No ___

17) Other relevant information:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

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I HEREBY CERTIFY THAT THE ABOVE

INFORMATION IS TRUE AND CORRECT

(Applicant's Signature)

Date:

Return the Original Application To:

Gerald P. Lepp, Esq.

ADR Administrator

United States District Court

Eastern District of New York

225 Cadman Plaza East

Brooklyn, NY 11201

ADR Department: Telephone (718) 613-2577

Fax (718) 613-2368