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Application for Use of the TMCA-Accepted Training Icon

Contact Name
Contact Title
Contact Phone Number
Contact Email Address
Training Organization Name
Training Organization Address
Training Organization City
Training Organization State
Training Organization Zip Code
Training Organization's Mediation Training Website or Webpage
Additional Contact Name
Additional Contact Title
Additional Contact Phone Number
Additional Contact Email Address

Applicant Certification

I, THEREFORE, CERTIFY THAT THE TRAINING ORGANIZATION ATTESTS TO THE FOLLOWING:
  • The 40-Hour Basic Mediation Training (the “training”) the Training Organization conduct meets TMCA’s training standards.
  • The TMCA-Accepted Training Icon will be used in the marketing materials for the training, including on the training’s webpage, and linked to the TMCA website at www.txmca.org.
  • The TMCA-Accepted Training Icon will appear on the training’s completion certificate (preferred) OR the training’s completion certificate will include the phrase "meets the training standards of the Texas Mediator Credentialing Association."
  • The TMCA-Accepted Training Icon will only be used within the year specified on the icon and only by the trainer whose application was approved for such use.
BY MY SIGNATURE BELOW, I FULLY ACKNOWLEDGE THAT THE TRAINING ORGANIZATION IS BEING GRANTED USE OF THE 2025 TMCA-ACCEPTED TRAINING ICON BASED ON ACCEPTANCE OF THE ABOVE TERMS AND THAT THE TRAINING ORGANIZATION WOULD NOT BE GRANTED USE OF THE 2025 TMCA-ACCEPTED TRAINING ICON BUT FOR THE TRAINING ORGANIZATION'S AGREEMENT TO ADHERE TO SUCH TERMS.
Please insert your full name and the current date here to electronically sign this application.
Name/Electronic Signature
Date