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Application for Use of the TMCA-Accepted Training Icon

Trainer Name
Trainer Phone Number
Trainer Email Address
Trainer Address
Trainer City
Trainer State
Trainer Zip Code
Trainer'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 I ATTEST TO THE FOLLOWING:
  • The 40-Hour Basic Mediation Training (the “training”) I 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 I AM BEING GRANTED USE OF THE 2025 TMCA-ACCEPTED TRAINING ICON BASED ON ACCEPTANCE OF THE ABOVE TERMS AND THAT I WOULD NOT BE GRANTED USE OF THE 2025 TMCA-ACCEPTED TRAINING ICON BUT FOR MY 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