Northern Illinois University
Student Mediation Services

Agreement to Mediation


I, ____________________________________, have entered into mediation with the Student Mediation Program with the intention of reaching an agreement to resolve my concerns regarding: (name of other party(s) in dispute) ____________________________________.

The provisions of this AGREEMENT TO MEDIATE are as follows:

I understand and agree that my participation in mediation is voluntary. The mediator is a neutral facilitator who will assist the parties to reach their own agreement to resolve their disputes. S/he will not make decisions about "right" or " wrong" or tell the parties what to do.

I understand that the mediator does not offer legal advice nor does s/he provide legal counsel.

I understand that, in order for mediation to work, open and honest communications are essential. Accordingly, all written and oral communications made in the course of mediation will be treated as privileged discussions and are absolutely confidential. Therefore:

Confidentiality Provisions

  • The mediator will not reveal anything discussed in mediation without the permission of both parties. It is understood that s/he is not required to maintain confidentiality if either party is in danger of bodily harm.
  • The parties agree that they will not at any time, before, during, or after mediation, call the mediator as witness, or attempt to use any documents produced in this process, in any legal or judicial proceeding concerning this dispute. The parties also agree that statements made/documents produced in this process will not be admissible in any legal or administrative proceedings.
The exception to the above confidentiality provisions is that this agreement to mediate and any written agreement made and signed by the parties as a result of mediation may be used in any relevant Northern Illinois University Student Judicial proceeding, when applicable.

While both parties intend to continue with mediation until an agreement is reached, it is understood that either or both parties may withdraw from mediation at any time. It is agreed that, if one or both parties decide to withdraw from mediation, best efforts will be made to discuss this decision in the presence of both parties and the mediator.

If the mediator determines that it is not possible to resolve the issues through mediation, the process can be terminated once this has been conveyed to the parties

When an agreement is reached, the mediator will prepare a Memorandum of Agreement.
Each party is advised to fully review the Memorandum of Agreement prior to signature.

I have read, understand, and agree to each of the provisions of this agreement.







Signature                                Date Signature                                Date