• The Association in brief
• Informations for the public
• Informations for mediators
• Activities calendar
• Annual Seminar
• To reach us
• Useful links

Become a member

To become a member, please complete the following form.

Connection information

E-mail Password Password confirmation

Personal information

Title Sir Mrs First name Last name Date of birth (AAAA-MM-JJ)

Phone number I agree to receive emails by the AMFQ concerning my membership. No Yes

Personal address / invoicing

Door number Street Apartment City Borough Postal code Province Outside of Canada Quebec Ontario Alberta British Columbia Prince Edward Island New Brunswick Manitoba Nova Scotia Nunavut Saskatchewan Newfoundland and Labrador Northwest Territories Yukon Country Canada Afghanistan South Africa Albania Algeria Germany Andorra Angola Antigua and Barbuda Saudi Arabia Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belau Belgium Belize Benin Bhutan Belarus Burma Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Burundi Cambodia Cameroon Cape Verde Chile China Cyprus Colombia Comoros Congo Congo Cook North Korea South Korea Costa Rica Côte d'Ivoire Croatia Cuba Denmark Djibouti Dominique Egypt UAE Ecuador Eritrea Spain Estonia U.S. Ethiopia Fiji Finland France Gabon Gambia Georgia Ghana Greece grenade Guatemala Guinea Guinea-Bissau Equatorial Guinea Guyana Haiti Honduras Hungary India Indonesia Iran Iraq Ireland Iceland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kyrgyzstan Kiribati Kuwait Laos Lesotho Latvia Lebanon Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Morocco Marshall Maurice Mauritania Mexico Micronesia Moldova Monaco Mongolia Mozambique Namibia Nauru Nepal Nicaragua Niger Nigeria Niue Norway New Zealand Oman Uganda Uzbekistan Pakistan Panama Papua - New Guinea Paraguay Netherlands Peru Philippines Poland Portugal Qatar Central African Republic Dominican Republic Czech Republic Romania UK Russia Rwanda Saint Kitts and Nevis St. Lucia San Marino Holy See Saint Vincent and the Grenadines Solomon Salvador Western Samoa Sao Tome and Principe Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Somalia Sudan Sri Lanka suede Switzerland Suriname Swaziland Syria Tajikistan Tanzania Chad Thailand Togo Tonga Trinidad and Tobago Tunisia Turkmenistan Turkey Tuvalu Ukraine Uruguay Vanuatu Venezuela Vietnam Yemen Yugoslavia Zaire Zambia Zimbabwe

Private professional information

Accreditation

Type of accreditation Temporary Permanent Temporary accredidation ending date (if applicable) Do you wish to be referred as mentor? No Yes

Years of experience

Year(s) of practice in Quebec in the profession of origin Year(s) of practice as a family mediator in Quebec Year(s) of practice outside of Quebec

Experience

Have you already published? No Yes Have you already given conferences? No Yes Have you already acted as supervisor in family mediation? No Yes Do you wish to act as supervisor in the future? No Yes Have you already acted as a trainer in family mediation? No Yes Have you already acted as an expert in Court? No Yes

Committees

To which committees are you interested to participate as voluntary member? Conference committee Training committee Publicity and promotion committee

Interests and suggestions

Fields of interest in family mediation (Example: general practice, co-mediation, multiculturalism)

Desired training (Indicate trainings (workshops or seminars) which you would like to see offered by the Association de médiation familiale du Québec.

Public professional information

Profession of origin Attorney Guidance counselor Notary Psychoeducator Psychologist Marriage and Family Therapist Social worker Other Second profession Attorney Guidance counselor Notary Psychoeducator Psychologist Marriage and Family Therapist Social worker Other None Do you wish to be referred as offsite mediator? No Yes Do you wish to be referred as international mediator? No Yes Do you wish to be referred as mediator in social paediatrics? No Yes Do you wish to be referred as a domestic violence mediator? No Yes Would you like to be referred for parental coordination? No Yes

Programme Justice Quebec No Yes Language(s) in which you offer your services French English Arabic Romanian Hebrew German Italian Spanish Creole Greek Hungarian Portuguese Chinese Japanese Yiddish Polish Bulgarian Slovakian Cambodian Quebec Sign Language Russian Bulgarian Turkish Vietnamese Armenian

Professional addresses

Your professional addresses will be visible on the map, as well as on your mediator card.

Add an address

E-mail Agreement

I agree to receive emails by the AMFQ concerning my membership. No Yes

• The Association in brief
• Informations for the public
• Informations for mediators
• Activities calendar
• Annual Seminar
• To reach us
• Useful links

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