THE
MEDIATION ACCREDITATION COMMITTEE
FORM B
APPLICATION FOR RENEWAL OF
ACCREDITATION
2025
INSTRUCTION NOTES
1. All accredited mediators are required to renew their accreditation status annually. An
applicant’s status on the register shall remain inactive until the renewal process is
complete. The application for renewal of accreditation must be submitted to the
Committee between 1st October to 31st December of every year.
2. Carefully read these instructions, the Accreditation Standards, the Mediator Practice
Rules, and the Code of Ethics for Mediators before filling the form. You should peruse
through the entire form before you commence the application process.
3. A soft copy of this form as well as the documents at (1) above can be downloaded at
www.judiciary.go.ke. One can also obtain a hard copy of the said documents from the
Mediation Accreditation Committee (MAC) offices during official working hours or
request for the same to be emailed via [email protected]. Applications
made on any other invalid form shall not be considered.
4. Please fill ALL the sections in BLOCK LETTERS. If the space is not sufficient, provide
further details on a separate A4 sheet. In case any section of the form is not applicable to
you, kindly indicate “N/A.”
5. Applicants are advised to provide all the information required in this form. The
Committee will not process any incomplete application.
6. Applicants applying for the first time for accreditation as mediators in the Family
and/or Children categories MUST satisfy the provisions specified at Part D of this form
and should submit two cases for assessment as required under that part.
7. Applicants are required to pay a non-refundable fee of ten thousand Kenya shillings
(Kshs.10,000) (USD 100). To make the payment, kindly request for an Invoice
note via our office number 0719300883. Money orders, postal orders, cheques, or
digital currency shall not be accepted.
8. The complete application should be submitted during office hours at the MAC offices at
Re-Insurance Plaza, Northern Podium, Taifa Road. It may also be scanned and
emailed as one pdf document to:
[email protected].
8. The application MUST be accompanied by the following documents:
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
a. Coloured copy of Identity Card or Passport. Non-citizens should attach a valid
coloured copy of identification document formally recognized by the country of
origin as an official document
b. Certificates for all trainings indicated as having attended
c. Proof of experience earned under part B (5)
d. Valid certificate of good standing from the respective professional bodies to
which the applicant has become a member
e. Valid tax compliance certificate
f. Valid certificate of good conduct. Non-citizens should submit clearance from
their respective security institutions
g. Valid work permit for non-citizens intending to practice in Kenya
h. Proof of payment of application fee of Kshs. 10,000 (USD 100)
i. Duly signed form G
9. All documents, unless submitted in original form should be duly certified. Non-citizens
should have all copies of their documents duly notarized.
10. The Committee upholds extremely high levels of professionalism, competence and non-
discrimination. Any form of canvassing shall lead to automatic disqualification of the
application.
11. MAC reserves the right to make the ultimate decision on the application in line with its set
standards and criteria for renewal of accreditation. Where the Committee requests for
further information or clarification, such information should be submitted promptly and
within the format, manner, and period prescribed in the request.
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
PART A
BASIC INFORMATION
1. Current personal information of the applicant
Title: Mr/Ms/Miss/Mrs/Dr/Prof/Hon./Rev. (tick the one applicable to the applicant)
Name Peris nyaga
ID/Passport Number Nationality
Marital status Organization/Firm
Physical Address
Phone Number Email
Gender Religion
Profession (other than mediation) D.O.B.
County of birth (if Kenyan) Tribe/Race
2. Professional bodies where the applicant became a member or ceased from
being a member within the past year
SN Name of professional Physical address, email, and Activity
body telephone (became or
ceased being a
member)
i.
ii.
iii.
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
PART B
REQUIREMENTS FOR RENEWAL OF ACCREDITATION
1. History of Court Annexed Mediation cases handled
Year of first mediation case in
judiciary
Mediation cases handled up to
30th September , 20
Number of completed cases
Number of pending cases
Number of cases with settlement
(including partial settlement)
Number of cases where parties
did not reach a settlement
2. History of private mediation (not under court annexed mediation)
Number of non-CAM mediation
cases/disputes handled up to
30th September, 20
Number of completed
mediations
Number of pending mediations
Number of mediations where
parties reached a settlement
(including partial settlement)
Number of mediations where
parties did not reach a settlement
3. CPD points earned (if exempted, please indicate ‘N/A’ and attach certificate
of exemption issued by the Committee and which must have been valid at the
time that the course was supposed to be undertaken)
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
SN Course title Institution Course Dates when Points
approval course was earned
code taken
i.
ii.
iii.
iv.
v.
vi.
4. Additional ADR related training not certified to yield CPD points
SN Course title Trainer Institution Dates when course
was taken
i.
ii.
iii.
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
5. Please indicate any other mediation related experience (other than training)
that you acquired over the past one year. (This may include experience
acquired as a trainer, coach, publisher, or through preparation of role plays
etc)
6. In what languages are you able to conduct mediation sessions? Please rate your
ability and/or fluency.
7. Kindly indicate your ability to conduct virtual mediation.
PART C
ACCREDITATION CATEGORY
Note well before filling part:
a) The Committee reserves the right to limit the number of court stations or categories of
accreditation that may be approved.
b) If approved, the selected category and court station are what will appear on the
Committee’s register for year under renewal.
c) The judiciary does not facilitate travelling and upkeep expenses for mediators and
parties who conduct their mediation sessions away from the court station of origin.
d) Mediators shall not be allowed to conduct mediation sessions away from the court
station of origin without the prior consent of all parties involved in the dispute and
where such consent is obtained, the mediator shall cater for his own travel costs and
upkeep.
1. Please indicate the category or categories of cases or types of disputes where
you wish to practice as a mediator for the renewal period
Civil □ Work injury claims □
Criminal □ Employment disputes □
Commercial transactions □ Insurance claims □
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
Labor relations □ Elections and political disputes □
Matrimonial (including property) □ Consumer rights □
Human rights □ Social and cultural rights □
Title to and use of land □ Succession disputes □
Environmental □ Disputes involving children □
Tax □ Non work injury claims □
Community mediation □ International relations □
Assessment of costs/fees □ Intergovernmental relations □
Disputes in education sector □ Maritime and outer space □
Intellectual property □ Natural resources □
Tribunals (please specify)
Any other (please enlist)
2. Kindly indicate the Court Station or Stations where you are willing to practice
as mediator for the renewal period
PART D
SPECIFIC REQUIREMENTS FOR MEDIATORS IN FAMILY/CHILDREN
MATTERS
Applicants applying for the first time to be accredited as mediators in the Family
and/or disputes involving Children categories MUST fill this part and should attach
at least two cases that meet the criteria set out below.
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
I confirm that I have at least three years working experience in the fields of
family law or family welfare/counseling and/or relevant working experience
which can demonstrate my competence in family work. (Please give details of work
experience and produce training certificates or reference letters issued by the
organizations for which the work was done for the demonstration of your competency in
family work)
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
PART E
LIMITING FACTORS
1. Has any of your application for accreditation been previously declined by any
professional body (including MAC)? (Please indicate Yes or No)
2. If the answer to number 1 above is Yes, please indicate the concerned body,
nature of application made, and reason for rejection
3. Do you have any pending proceedings against you, previous convictions, or
any adverse findings/judgments by any court, commission of enquiry or
tribunal? (Please indicate Yes or No)
4. If the answer to number 3 above is Yes, please explain
5. Are there any pending or completed disciplinary actions against you by MAC
or any other body? (Please indicate Yes or No)
6. If the answer to number 5 above is Yes, please explain
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
7. Have you ever been adjudged bankrupt or made any composition with
creditors? (Please indicate Yes or No)
8. If the answer to number 7 above is Yes, please give details (you may opt not to
answer this question)
9. Please provide any other information not covered above and which you
consider relevant to your application for renewal of accreditation
PART F
USE OF DATA
Persons who supply data in their application to the Mediation Accreditation
Committee are advised to take note the following:
1. The information provided in the application will be used for the purpose of
assessment for accreditation as a mediator or for related purposes and may be
shared with third parties for purposes and for reasons connected therewith.
2. After the application has been duly processed, the Committee will retain the
documents in a file and/or electronic register for as long as it deems necessary
or useful.
3. An applicant has the right to request access to, and the correction of, his
personal data as retained by the Committee. Applicants wishing to access or
make corrections to their data should submit written requests to the Mediation
Registrar.
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
PART G
DECLARATION BY APPLICANT
1. I have read and agreed to the Use of Data Notice at paragraph F above.
2. I authorize the Committee and any other authorized person to deal with,
utilize and/or access the data submitted as may be necessary.
3. I understand that my data will become part of the Committee’s records and
may be used for all purposes deemed necessary or useful.
4. I declare that the information given in support of and in connection with this
application is accurate and complete. I understand that any misrepresentation
will disqualify my application and may lead to revocation of my accreditation
as a mediator. I also understand that the Committee reserves the right to report
the matter to the relevant professional body or institution.
5. I confirm that I am familiar with and will adhere to the Committee’s Code of
Ethics for Mediators, the Accreditation Standards, the Mediator Practice Rules,
and the Mediation Rules.
6. Any information provided in the application may be made available by the
Committee to third parties for the purposes of mediator assessment, selection
or for related purposes.
7. I undertake to inform the Committee promptly if and when I am charged with
any criminal offence during the time that I shall remain as an accredited
mediator or where I lose or terminate my accreditation/membership with any
professional body.
Please sign below to confirm the accuracy of the information contained in the
application and the confirmation of your agreement to the use and disclosure of the
same.
Signature:
Date:
Name:
MEDIATION REGISTRAR
MEDIATION ACCREDITATION COMMITTEE
Reinsurance Plaza-Northern Podium
Opposite Supreme Court Building, Taifa road
P.O Box 30041-00100
Nairobi
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
FORM G
COMMITMENT BY THE MEDIATOR
I ..................................................................................................................................... do state as follows;
a) That I have read the Code of Ethics for Mediators, the Accreditation Standards, the
Mediator Practice Rules, and the Mediation Rules.
b) That I have understood the contents of the said documents and I am fully aware
of the import and purpose of the said documents.
c) That I commit myself to abide by the said documents as well as any other relevant
rules and regulations governing the conduct of mediation.
d) That I further commit to be bound by the Code of Ethics adopted by the Mediation
Accreditation Committee.
Dated at ……………………………...this …………...day of ……….………….20….…..
Signature…………………………………………...
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The Mediation Accreditation Committee of Kenya: Mediation for peaceful and better lives
