Digital Signature* By my signature on this Agreement to Mediate, I acknowledge my rights, and agree to the terms of the mediation procedures as stated above. I hereby affirm that I have the authority to enter into and sign a binding written agreement to settle this complaint.
I wish to challenge: To select multiple items in a list, hold down the Ctrl(PC or Command (Mac) key. Then click on your desired items to select.
Anderson, Charlene Ando, Gary Armbruster, Kristin Barile, John Bouldin, Bruce Bowen, Carla Brown, Janine Craig, Deidre Dickinson, D. Deems Dignan, Larry Dragos, Chad Elia, Joseph Emptage, Tomyal Enriquez, Wednesday Eslinger, Holly Flucke, Sue Fouts, Duane Frutkin, Maxine Gomez, Richard Grammond, Judith Guess, Jared Gutteridge, Darlin Hammond, Jon Johnson, Amy Jones, Clark Jones, KC Karpen, Sandy Keely, Rosemary Kiley, Jennifer Koch, Jodi LaBell, Fred Lavine, Amy Leiber, Butch Lichter-Roedig, Leah Louks, Judy Mabery, Holly Marian, James Massingale, Tim McNicol, Cynthia Meinerz, Michael Moore, Trudy Murray, Jeff Ortega, Elisabeth Ostrowski, Shelley Palmer, Yvette Pinciaro, Carol Rauch, Peggy Rea, Nancy Roberts, Ronald Rogers, Mary Alice Russell, Gerry Sack, Rick Serven, Paula Schenck, Joette Sexton, Philip Shields, Debbie Stephens, David Suarez, Lisa Swinney, William Taylor, Becky Tennyson, Matthew Terpening, Cheryl Vickery, Tonia Warren, Lynn Weiss-Portnoff, Wendy Zollinger, Kellydawn
I (we), as party to the matter hereby Challenge: the qualification of the following named individual(s) as a member(s) of the Hearing Panel for the following reasons: (NOTE: Unsubstantiated Challenges will be disregarded.)