PANEL APPLICATION FORM - Arbitration

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The Arbitration Foundation of Southern Africa PANEL APPLICATION FORM (GENERAL commercial PANEL AND MEDIATION PANEL ) For office use only NAME OF APPLICANT DATE OF APPLICATION DATE OF PROCESSING CERTIFICATE OF APPOINTMENT ISSUED:_______ CODE OF CONDUCT SIGNED:________ SIGNATURE OF PROCESSOR 1 INTRODUCTORY OBSERVATIONS 1. Please complete this form in typescript if possible. 2. The information that you supply will be entered in a database maintained by AFSA. In the event that your name is proposed as a mediator or arbitrator to parties to a dispute, the information that you supply will also be made available to those parties.

The Arbitration Foundation of Southern Africa PANEL APPLICATION FORM (GENERAL COMMERCIAL PANEL AND MEDIATION PANEL) For office use only NAME OF APPLICANT

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