Center for Conflict Resolution - Demand to Arbitrate Form

I, the undersigned (Petitioner), hereby petition the BYU Center for Conflict Resolution to initiate arbitration with the Respondent named below in accordance with the dispute resolution clause of my BYU rental contract. (Parties must attempt to settle the dispute in the mediation process first before demanding arbitration unless the CCR determines there is good cause to bypass mediation.)

Case #:

Petitioner (party initiating this process)
Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
Email:
Fax:

Respondent (party upon whom this Demand is made - the defending party)
Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
Email:
Fax:

Please attach a copy of the contract involved in the dispute.

I, the Petitioner, demand relief from the Respondent named above for the following reasons:

Brief Summary of Issues in Dispute: (Please limit your response to 300 words.)

Remedy Sought: Include amounts claimed, if any (Please limit your response to 300 words.)

Note: When there is more than one petitioner in a case, each petitioner must submit a Demand to Arbitrate. Only one filing fee of $15.00 needs to be submitted for all petitioners of the same case. Mail the $15.00 filing fee or bring it in to the Center for Conflict Resolution, 4412 WSC, Provo, UT 84602-7933.

Submitted By (by entering your name here, you are adding your digital signature.):

By submitting this form, I am confirming that the information provided is true and correct.