New Hampshire Code of Administrative Rules
Fam - Board of Family Mediator Certification
Chapter Fam 300 - CERTIFICATION REQUIREMENTS
Part Fam 302 - APPLICATION PROCEDURE
Section Fam 302.04 - Required Documentation

Universal Citation: NH Admin Rules Fam 302.04

Current through Register No. 12, March 21, 2024

In addition to the completed application form the applicant shall submit or otherwise arrange for the board to receive:

(a) As an attachment to the application form, an authenticated transcript or similar authenticated document showing that the applicant received the education required by Fam 303.02;

(b) As an attachment to the application form, documentation issued by the training provider showing receipt of the core mediation training required by Fam 303.03(a), including:

(1) The name of the certified New Hampshire family mediator training program or the name of the advanced practitioner or advanced educator member of the Association for Conflict Resolution or CRO who presented the training, as applicable;

(2) The topic(s) of the training;

(3) The total number of training hours;

(4) The number of hours the applicant attended which were devoted to:
a. Role play as further described in Fam 604.06; and

b. Ethics as described in Fam 303.05(g); and

(5) The beginning and ending dates of the training;

(c) As an attachment to the application form, documentation issued by the training provider showing receipt of the mediation training specific to New Hampshire required by Fam 303.03(a)(1)b., including:

(1) The name of the provider;

(2) The topic(s) of the training;

(3) The number of training hours; and

(4) The date of completion of the training;

(d) As an attachment to the application form, documentation issued by the training provider(s) showing receipt of the domestic violence training required by Fam 303.03(a)(1)c., including:

(1) The name of the provider;

(2) The number of training hours; and

(3) The date of completion of the training;

(e) If applicable, as an attachment to the application form, documentation issued by the provider(s) showing receipt of the 12 hours of continuing education specified in Fam 303.03(a)(2)b., including:

(1) The name of the provider;

(2) The topic(s) of the training;

(3) The number of training hours; and

(4) The date of completion of the training;

(f) As an attachment to the application form, documentation of completion of the applicable internship requirements of Fam 303.07, including:

(1) A list of the cases co-mediated, indicating for each case on the list the number of hours spent on the case and the name of the supervisor;

(2) Copies of the case summary forms required by Fam 303.07(g); and

(3) Copies of the mediated agreements specified in Fam 303.07(c)(2) or Fam 303.07(e)(2), as applicable, with information identifying the parties redacted, but no more than 5 such mediated agreements;

(g) If applicable, as an attachment to the application form, the following documentation of qualification as a family law practitioner as described in Fam 303.08:

(1) A photocopy of a transcript or diploma showing graduation from law school; and

(2) A letter of good standing as an active member of the bar issued by the New Hampshire Supreme Court dated within 3 months of the date the application is submitted to the board;

(h) If applicable, as an attachment to the application form, the following documentation of qualification as a mental health practitioner as described in Fam 303.08:

(1) A photocopy of a transcript or diploma showing receipt of a master's degree or a higher academic degree; and

(2) A letter of good standing from the board of mental health practice dated within 3 months of the date the application is submitted to the board;

(i) If applicable, as an attachment to the application form, photocopies of any licenses, certifications, or other documents authorizing the practice of mediation or other profession issued to the applicant by any domestic or foreign governments;

(j) If the answer to either Fam 302.03(c)(17) or Fam 302.03(c)(18) is affirmative, as an attachment to the application form a statement disclosing and describing the facts in detail;

(k) If the answer to any part of Fam 302.03(c)(19) is affirmative, as an attachment to the application form, a statement disclosing and describing the facts in detail, including:

(1) For a finding of abuse as described in the question:
a. The jurisdiction and court;

b. The finding of the court; and

c. The date of the finding;

(2) For the revocation of a professional license or certification as described in the question:
a. The type and the number of the professional license; and

b. The jurisdiction and name of the revoking authority; and

(3) For a conviction described in the question:
a. The jurisdiction and court;

b. The date of the conviction; and

c. The charge(s) of which the applicant was convicted;

(l) For each case co-mediated with an internship supervisor, an evaluation written and sent directly to the board by the internship supervisor which addresses the applicant's knowledge and skills in each of the topics listed in Fam 303.05 and Fam 303.06; and

(m) A total of 3 signed letters of recommendation as further described in Fam 302.05, sent directly to the board by the individuals writing them.

#5609, eff 4-6-93, EXPIRED: 4-6-99

New. #7716, INTERIM, eff 6-22-02, EXPIRED: 12-19-02

New. #7917, eff 7-11-03; ss by #8719, eff 11-1-06; ss by #8930, eff 7-4-07; ss by #9674, eff 4-2-10 (see Revision Note at chapter heading for Fam 300)

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