Conflict Resolution Education - National Criminal Justice Reference ...

Provider Competency Assessment Form
Qualifications and training in conflict resolution:
Training in negotiation theory? ❑ Yes ❑ No
If yes, where received? ___________________________________________________________
When? ________________________________________________________________________
Training in mediation? ❑ Yes ❑ No
If yes, where received? ___________________________________________________________
When? ________________________________________________________________________
Experience:
Served as a mediator? ❑ Yes ❑ No
If yes, what were the experiences? __________________________________________________
_______________________________________________________________________________
School-based experience in education? ❑ Yes ❑ No
If yes, what were the experiences? __________________________________________________
_______________________________________________________________________________
Implemented a school conflict resolution program? ❑ Yes ❑ No
If yes, what types of programs? ____________________________________________________
_______________________________________________________________________________
Number of years providing staff development in conflict resolution. _______________________
Has trained students in conflict resolution? ❑ Yes ❑ No
Has trained teachers in conflict resolution? ❑ Yes ❑ No
Has trained administrators in conflict resolution? ❑ Yes ❑ No
Has trained other school staff in conflict resolution? ❑ Yes ❑ No
Has trained parents in conflict resolution? ❑ Yes ❑ No
Approximate number of people that have been trained by staff developer: __________________
Involvement in school reform initiatives? ❑ Yes ❑ No
If yes, what was the involvement? __________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
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