Mediation Request Form

    Please Read 

    • Parties who wish to apply for mediation under MTI EA Mediation Centre Rules must complete this Request for Mediation form.

    • Please copy all the relevant parties to the dispute when sending the Request for Mediation to MTI East Africa.

    Fee

    • Please note that the non-refundable filing fee of Kshs 50,000 (inclusive of VAT) per party will be payable within three (3)working days after MTI East Africa acknowledges the receipt of this Request.

    • MTI EA will process this request upon full payment of the filing fee

    Details of Parties 

    Note; Where there are more than 2 parties, please provide the details for them in a separate Attachment

    Applicants

    Respondents

    Details of Dispute

    Available Dates for Mediation

    Please provide a few available dates - if possible, mutually agreed dates

    Mediator Preferences

    (Please note that when parties choose their own mediator, the selected Mediator(s) is/are entitled to charge his/her commercial rates. MTI E.A 's published Fee Schedule will not be applicable)

    Signature