My neighbour and I can actually talk about things without having to shout and argue. It’s a real relief.

- Deborah, Wandsworth resident.

Family Mediation Registration Form

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Full Name *

Address *

Home phone *

Mobile phone

Income *

£0 - £41,500

£41,501 - £59,999

£60,000+

If your annual gross income is less than £41,500 per annum, please read and complete the income confirmation statement below.

Please type your full name as indication of your agreement with the statement below. By typing in your name it is taken as the equivalent of signing a paper form manually.

"I confirm that my annual gross income is less than £41,500 per annum. I understand that by signing this form to this effect I am making a statement of fact and will be able, if asked, to provide WMS with evidence (e.g. payslips or copies of bank statements) of this)."

Attendance availability *

Anytime between 9 - 6 pm.

9.30 AM - 12.30 PM

1.30 PM - 4 PM

6 PM - 9 PM

It really helps us set up meetings and the mediation as soon as possible if you can give us as much information about your availability.

Attendance - additional comments

Additional Comments around availability to attend mediation: (e.g. can attend only within school hours).

Where did you hear about WMS? *

Other

Please state where you heard about WMS if you selected "Other" above..

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Math question * 4 + 13 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.