I attended the following alternative dispute resolution continuing education course/conference: (Please use reverse side or attach a separate sheet to report more than one course and include a copy
of your training certificate.)
Dates(s): _______________________ ______
Hours of actual education: ___________________________________________
Please list your speciality areas: _________________________________________________
I do hereby certify that the information provided is true and that I meet the qualifications required
in North Dakota Rules of Court Rules 8.8 and 8.9.