Arbitration Application

Name
First Last
Title
Most Recent Employer
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Dates Employed
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Cell
Preferred Mailing Address
- Home
- Office
College
Degree and Date
Graduate
Degree and Date
Other
Degree and Date
Professional Licenses: (State and Date)
Professional Associations:
Member Arbitrator Rosters:
Per Diem Fee
Cancellation
Other
In approximately 100 words, please list your experience as a labor-management arbitrator, mediator and/or fact finder, the type of issues dealt with, whether in the private or public sector, the industries covered, service on any ad hoc or permanent boards, and any other academic or professional work that qualifies you in technical matters. Include the names of companies and unions involved in permanent arbitrator designations. In addition, you may submit a CV/Resume.
CV/Resume
Max. file size: 50 MB.
Submit the names and contact information of employer and union representatives, arbitrators and other neutrals who have known your work. Please give names in each of the three categories, with at least one name from an Employer Representative, Union Representative, and Neutral (Arbitrator, Mediator, Factfinder).
I understand that the composition of the Roster and the right to make changes there-in and deletions therefrom are within the discretion of the Louisville Labor-Management Committee and that no Roster member acquires rights to inclusion of his/her name thereon.
MM slash DD slash YYYY
Signature

Arbitration Application

Labor

Management

Public

Address

Phone