Form 1a - Application For Ncia Arbitrator Panel Status - Nairobi Centre For International Arbitration Page 2
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4Nairobi Centre for International Arbitration - NCIA Arbitrator Panel Status Standard
Mailing address _______________________________________________________________________________________________
Country: ________________________City: _____________________ Postal Code: _____________________________________
Telephone (
) ________________________ Fax (
) ___________________________________
Email address: _______________________________________________________________________
Primary Occupation: ________________________________________________________________
2. EDUCATION
(i) Level of Academic Qualification*
Degree or Certificate(s)
Year Awarded
Name of Institution
(ii) Arbitration Training*
(iii)
Other training in dispute resolution**
* Attach proof of qualification and training.
** (If you have been involved in such training as a facilitator, trainer or instructor, give a
description of your role.)
3. ARBITRATION EXPERIENCE
a) Indicate the number of Arbitrations, if any you have acted and the role in the areas specified
in the table below;
Commercial Construction
Investor/State
Other(Specify)
Sole Arbitrator
Member-
Arbitration
Panel
Counsel/Agent
b) Number of years you have acted as an Arbitrator?________________________________________________
(please attach a brief resume/curriculum vitae/profile).
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