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PANEL APPLICATION FORM - Arbitration

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. 3. Please use the blank pages provided in this form for supplementary details. 4. Explanatory and Guidance Notes on certain of the items on which information is requested are contained in footnotes.

The Arbitration Foundation of Southern Africa PANEL APPLICATION FORM (GENERAL COMMERCIAL PANEL AND MEDIATION PANEL) For …

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