OMA Membership Form

PO Box 40041

Portland, OR 97240

Phone: 503-872-9775

Oregon Mediation Association

Membership Application and Renewal Form

Thank you for joining the Oregon Mediation Association (OMA) or renewing your membership! Please complete all of the fields below and then click on the submit button to proceed to the payment page. Please contact the OMA office at oma@omediate.org or (503) 872-9775 if you have any questions. We appreciate your support!

Name

first last

Title

Company

Address

	street line 1
	street line 2
,	city, state/prov zip

Phone

Fax

Alternate Phone

Website

Standards of Practice Agreement (SOPA)

"I am a mediation practitioner. I have read and will abide by the OMA SOPA."
"I am not a mediation practitioner."

(Required)

Membership Type

New Membership
Renewal

(R)

Membership Level

Full-time Student ($25 annually)
Unpaid Practitioner ($35 annually)
Friend of Mediation ($65 annually)
Paid Practitioner ($85 annually)
Non-Profit Organization ($175 annually)
For-Profit Organization ($275 annually)
Lifetime OMA Membership (One time contribution of $1500 or more)

(R)

OMA Committees - Please indicate those you are interested in joining.

Conference (Annual Conference Planning)
Leadership (Financial & Leadership)
Legislative (Monitoring Legislation)
Membership Services (Member Support & Activities)
Newsletter (Writing/Reporting/Editing/Graphics)
Standards & Practices (Core Standards and Ethics)

OMA Special Interest Groups - Please indicate those you are interested in joining

Elder Mediation
Family Mediation
Workplace Mediation
Neuroscience

Please be sure to complete your online payment via PayPal on the next page in order to complete the membership process. If you have any questions, please contact us at oma@omediate.org.

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