Panelist Enrollment Form - CPR Institute for Dispute Resolution

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Panelist Membership Application
This membership is exclusively available to individuals who have been accepted on CPR's Panels of Distinguished Neutrals. Panelist
and Individual members will be recognized by first and last name not by affiliation. If you are not a CPR Panelist and would like to
become a member visit www.cpradr.org. For questions or assistance, contact Terri Bartlett, Director of Membership, at (646) 753-
8225 or tbartlett@cpradr.org.
Personal Contact Information:
❑ Mr. ❑ Ms. ❑ Hon. First: __________________________________Last: ______________________________________Suffix:_____
Affiliation (if applicable): ________________________________________________________________________________________
Address: _____________________________________________________________________________________________________
City: ___________________________________________State: _______________ Zip/Postal: _______________________________
Country: _____________________________________________________________________________________________________
Telephone:______________________________________________Fax:__________________________________________________
Email: _______________________________________________________________________________________________________
Assistant Information (if applicable):
Name of Assistant: _____________________________________________________________________________________________
Telephone: ____________________________________ Email: ________________________________________________________
Committee Participation: Membership includes participation on 1 Committee.
Note: Each additional Committee is $65.00 per year
Please select from the list below:
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Arbitration Committee
Asia-Pacific Advisory Council
Banking and Financial Services Committee
Brazil Advisory Council
Construction Advisory Committee
D&O Insurance Committee
Diversity in ADR Task Force
Employment Disputes Committee
Energy, Oil and Gas Committee
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European Advisory Committee
Franchise Mediation Program
Health Care and Life Sciences Committee
Mass Claims Commission
Mediation Committee
Patent Mediation Task Force
Product Liability Committee
Sports Law Committee
Panelist Membership: $2,000.00
Includes base fee for one panel and one year of membership. (Savings of $190)
Additional Panel Listings:
Each Additional Listings from 2 to 3 additional panels = $100 per panel
Each Additional Listings from 4 to 6 additional panels = $80 per panel
Each Additional Listings for 7+ panels = $60 per panel
Upon receipt, you will receive a Membership Payment Form which will include your additional panel fees if applicable.
Please print and mail, fax, or email to:
CPR Institute
Membership Department
575 Lexington Avenue, 21 st Floor
New York, NY 10022
Fax: +1.212.949.8859
tbartlett@cpradr.org

Panelist Membership:
The Competitive Advantage
Panel Membership offers a convenient option to combine a membership in CPR with your listing
on the CPR Panels of Distinguished Neutrals.
In today’s competitive market, the continued success of your practice is dependent on having a
constant and high-profile presence in order to cultivate current and new business. The new “CPR
Panel Membership” offers a full range of member benefits including access to cutting-edge
resources and targeted networking opportunities to strengthen your position as a leader in ADR.
What Member Benefits Will I Receive?
• Innovative Online Dispute Resolution Processes
• Five Unvetted Lists of Neutrals Per Year
• Topic Calls Moderated by CPR’s Highly Distinguished Neutrals
• Opportunity to Moderate and/or Present during Topic Conference Calls
• Thought Leadership that Develops Global Best Practices
• Targeted Networking Opportunities
• Opportunities for Speaking Engagements
• Participation on One of CPR’s Industry Committees
• Unlimited Electronic Access to Alternatives
• Opportunities to Write Articles in Alternatives
• Alternatives App for your iPhone/iPad/iTouch
• Access to CPR’s Model Clauses & Rules
• Latest ADR Developments, Techniques & Best Practices
• Free or Discounted Cutting-Edge ADR Tools & Resources
• Membership Matters – CPR’s Exclusive E-Newsletter
• Discounted CLE Training
• Discounts on CPR Conferences & Events
• Discounts on ADR Publications
• Research & Drafting Assistance from CPR Staff
What Does A Panelist Membership Cost?
Membership will not impact nor influence case assignments. The annual contribution for a
Panelist Membership is $2,000. It includes your membership contribution and your base fee
for one panel ($395) for a total savings of $190. If you are on more than one panel, the
following prices apply:
Each Additional Listing (from two to three additional panels): $100
Each Additional Listing (from four to six additional panels): $80
Each Additional Listing (for seven or more additional panels): $60
How Can I Find Out More About A CPR Membership?
Contact Terri Bartlett, Director of Membership at 1-646-753-8225 or membership@cpradr.org
International Institute for Conflict Prevention and Resolution
575 Lexington Ave., 21st floor | New York, New York 10022
Phone: +1.212.949.6490 | Fax: +1.212.949.8859 | info@cpradr.org
Visit us on the web at www.cpradr.org