New Member & Renewal Application | Massachusetts Council on Family Mediation

PLEASE READ the following information BEFORE you complete the application form:

► MCFM offers individual memberships only. Find out more about MCFM memberships

► Dues:

Premium membership (with online Referral List and profile): $190 per year
Basic membership: $90 per year.

► New Members:

Your membership will be activated upon receipt of your payment. MCFM will send an email from info@MCFM.org containing your account and login information for the MCFM website. You must log in to your member account to make changes to the information on this form and to view members-only content.

► Renewing Members:

Your latest member information should be prefilled in the form below. If not, STOP.

Please follow the special link from your renewal reminder email OR log in to your member account and click 'Renew Now' under 'Member Status' in the right sidebar. Your member information will now be prefilled in the form below, and your payment will be properly applied to your member account.

If your membership expired before October 1, 2015, please email the MCFM Administrator for assistance.

► Payment:

MCFM accepts online credit card payments only (Visa/MasterCard/Discover/Amex). After you submit your application, you will be taken to our payment page. Enter your billing name and billing address as they appear on your credit card statement. If there is a mismatch, MCFM's credit card processor will decline your payment. MCFM does not process offline transactions.

Press the 'Submit' button ONCE on the payment page and wait. You will receive an onscreen confirmation when your payment has been processed.

QUESTIONS? Email the MCFM Administrator

PLEASE NOTE: All fields marked with an * in the form below are required.

Member Contact Info

This section is just for MCFM to contact you. You can enter your address for the Member Directory and the Referral Directory in the "Online Directories: Office Locations" section below.

First Name

Nickname: What are you called by your friends and colleagues? (For example: 'Bob' for Robert, 'Liz' for Elizabeth). If you go by your first name as it appears above, please reenter it below.

Nickname

Last Name

Phone Number

Mailing Address

Please enter your BUSINESS MAILING ADDRESS below. MCFM will use this address for official purposes only.

Business Name

Business Street Address

City

State/Province

Zip Code

Mailing Lists

MCFM will notify you by email of all MCFM activities and events and will forward professional news and events from an approved list of nonprofit third parties. Both of these lists are low-volume and will help keep you informed. You may unsubscribe from either group at any time by logging in to your member account or by clicking the 'unsubscribe' link at the end of any MCFM email. NEW MEMBERS: MCFM encourages you to check BOTH mailing lists.

Mailing lists

Third Party Announcements

MCFM Member Announcements

Online Directories: Office Locations

Physical Office Locations: All MCFM members may list one office location (address and phone number) in the online Member Directory. Premium members may list up to two locations in the online Referral Directory. Business email addresses and website addresses are published for Premium members only.

All members should complete Physical Office Location #1. Premium members with a second office should also complete Physical Office Location #2.

Physical Office Location #1

Street Address

City

State

Zip Code

Phone Number

Website

Physical Office Location #2

PREMIUM MEMBERS ONLY

Street Address

City

State

Zip Code

Phone Number

Online Directories: All members are included in the Member Directory. Premium members are included in the Referral Directory. If, for any reason, you would prefer NOT to be included in these directories, please select 'No' below.

Display in Member Directory?

Yes

Display in Referral Directory?

Yes

Membership Type

Basic Membership - $90

Premium Membership - $190

Membership Certification

NOTE: You must complete the following certification section in order to join MCFM or to renew with MCFM.

You are in good standing in your profession.
You will uphold MCFM's Standards of Practice. Review the MCFM Standards
You will hold MCFM harmless from claims arising from your mediation practice, including any errors or omissions in MCFM's directories.

Questions? Contact us.

Self Certification

I agree I am in good standing, will uphold MCFM"s standards and will hold MCFM harmless from claims.

Premium Certification

Premium Members must also certify that they have completed 30 hours of mediation training AND are currently practicing mediation professionally.

Premium Certification Statement

I certify I've completed 30 hours of mediator training AND am currently practicing mediation in my practice.