Form No. TAF 1

Reconciliation, Negotiation, Mediation and Arbitration (Practitioners
Accreditation)
GN. NO. 147 (Contd.)
___________
FIRST SCHEDULE
___________
UNITED REPUBLIC OF TANZANIA FORM No TAF 1
APPLICATION FOR ACCREDITATION

(Made under regulation 8)
Application 1. Accreditation Application Kit shall contain:

instructions (a) Application Form
(b) Reference Form
(c) Procedure Resume of Practice must also be submitted at the time of
application.
2. tick the boxes and insert details where relevant.

3. All other materials in response to other sections must be provided via a
submission and documentary evidence format.
4. Applications will not be accepted unless accompanied by payment or proof of
payment of the application fee.
5. The completed application form and payment should be sent to
The Registrar,
Ministry of Constitutional and Legal Affairs,
Government City,
Mtumba Area
P.O. Box 315,
DODOMA, TANZANIA
Email: [email protected]
6. This application form should be read together with the Civil Procedure Code,
Cap. 33 and the Arbitration Act, Cap. 15 and any other rules or regulations
providing for minimum standards which apply to any person who voluntarily
seeks to be accredited to act as a Reconciliator, Negotiator, Mediator or
Arbitrator and assist two or more participants to manage, settle or resolve
disputes or to form a future plan of action through a process in respect of
reconciliation, negotiation, mediation or arbitration.
7. This application form should be read together with the practice standards that
apply to Reconciliator, Negotiator, Mediator or Arbitrator to a specific trade
where decisions are made. For example, reconciliation, negotiation, mediation or
arbitration is used in relation to commercial, investment, community, workplace,
environmental, construction, family, building, health and educational decision
making.
13
Accreditation)
A. APPLICANT’S PARTICULARS
(a) Full Name: ………………………..
(b) Name to be displayed on Certificate:………………………………
(c) Name of firm or organization………………………………………
(d) Mailing address (All general mail will be sent to this address):…………
(e) Telephone:………………………………
(f) Email (email will be the main method of communication):……………….
NOTE: In the statement below tick “Yes” if you agree.
1. I have read and understood my obligations under the Reconciliators, Negotiators,

Mediators and Arbitrators (Accreditation) Regulations 2021 □Yes □No
2. The Code of and Practice for Reconciliators, Negotiators, Mediators and

Arbitration require Reconciliators, Negotiators, Mediators or Arbitrators who
apply to be accredited to provide evidence of ‘good character’. With respect to
the requirement to be of ‘good character’, thus:
(a) I have provided evidence that I am regarded as honest and fair, and that I am
regarded as suited to practice □ Conciliators, □Negotiators, □Mediators or
□Arbitrators (tick only one box as appropriate) by reference to your life, social
and work experience. Please provide written references from three members of
the community who have known you for more than three years demonstrating
your good character.
(b) I have submitted three written reference reports (annexure A) from persons
listed below who can attest to my competence and my involvement in this area
of practice, one of them being from the Local Government Authority in my
locality □Yes □No
3. I am willing to be submitted for character check area that I will practice □Yes
□No
4. I have no record of serious conviction or impairment that could influence my

capacity to discharge my obligations in a competent, honest and appropriate
manner □Yes □No
5. I have submitted documentary evidence that I am accredited with an existing

scheme that has existing ‘good character’ requirements that I comply with (for
example, by referring to an existing Professional Association, School of Law, or
Bar Association, where relevant) □Yes □No.
6.I have not been disqualified to practice by another professional association

relating to any other profession (for example, a Professional Association, School
of Law, or Bar Association □Yes □No, if ‘No’ please explain the circumstances
under which you have previously been removed.
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………
7. I have not been suspended from acting as a mediator under the standards □Yes
□No
8. I undertake to comply with any relevant legislation and any other approval
requirements that may relate to particular schemes □Yes □No
14
Accreditation)
B. TRAINING AND EDUCATION

1. I have provided documentary evidence that I have appropriate □reconciliation,
□negotiation, □mediation or □arbitration (tick only one box) competence, by
reference to applicable practice standards, as well as my qualifications, training
and experience □Yes □No.
2. I have provided the name of the education and training course(s) I have
undertaken and in what year the said courses(s) were completed □Yes □No.
3. I confirm that the education and training course(s) satisfy the following:
(a) was conducted by a training team comprised of a at least two
instructors where the principal instructor[s] has more than three
years’ experience as a □Reconciliators, □Negotiators, □Mediators
or □Arbitrators (tick only one box as appropriate) and has complied
with the continuing accreditation requirements set out in Para. 6 of
the Approval Standards for that period and has at least three years’
experience as an instructor □Yes □No; and
(b) has assistant instructors or coaches with a ratio of one instructor or
coach for every three course participants in the final coached
simulation part of the training and where all coaches and instructors
are accredited; □Yes □No;
(c) is a program of a minimum of 38 hours in duration (which may be
constituted by more than one mediation workshop provided not
more than twelve months has passed between workshops),
excluding the assessment process referred to in Section 5(2) of the
Approval Standards □Yes □No; and
(d) involves each course participant in at least nine simulated sessions
and in at least three simulations each course participant performs
the role of □Reconciliators, □Negotiators, □Mediators or
□Arbitrators (tick only one box as appropriate) □Yes □No; and
(e) provides written, debriefing coaching feedback in respect of two
simulated sessions to each course participant by different members
of the training team □Yes □No.
4. I have completed to a competent standard a written skills assessment of

□Reconciliators, □Negotiators, □Mediators or □Arbitrators (tick only one box as
appropriate) competence □Yes □No.
5. I have worked as a □Reconciliator, □Negotiator, □Mediator or □Arbitrator (tick

only one box as appropriate) prior to submitting this application and have
experience, training, and education that will satisfy the Panel that I am equipped
with the skills, knowledge and understandings set out in the core competencies
referred to in the Practice Standards.
C. REFERENCES
Referee No. 1
Name:…………………………………….
Professional Title:…………………………
Firm/Employer: …………………………..
Email:…………………………………….
Phone:…………………………………….
Referee No. 1
Name:……………………………………..
Professional Title:………………………….
Firm/Employer: …………………………….
15
Accreditation)
Email:………………………………………..
Phone:……………………………………….
Referee No. 1
Name:………………………………………..
Professional Title:…………………………..
Firm/Employer: ………………………………
Email:……………………………………….
Phone:………………………………………
D. AGREEMENT AND SIGNATURE:
I, ……………being an applicant for accreditation as a □Reconciliator, □Negotiator,

□Mediator or □Arbitrator (tick only one box as appropriate) under these Regulations,
(i) Consent to the Panel, making such enquiries as it sees to determine my
eligibility and suitability for accreditation.
(ii) Agree to accept the terms and conditions for accreditation as set out in
the Panel.
(iii) If accredited, agree to comply with the laws and other applicable
instruments and any rulings of the Panel relating to accreditation or
reaccreditation.
(iv) Certify that the content of this application is true and correct to the best
of my knowledge.
Signature: ………………… Date:……………………….
Annexure REFERENCE FOR A DISPUTE RESOLUTION PRACTITIONER SEEKING

ACCREDITATION UNDER THE RECONCILIATORS, NEGOTIATORS,
MEDIATORS AND ARBITRATORS (PRACTITIONERS ACCREDITATION)
REGULATIONS, 2021
Applicant’s Name: …………………………………….
The practitioner named above has applied for accreditation under the above cited
Regulations. To become accredited as a □Reconciliator, □Negotiator, □Mediator or
□Arbitrator (tick only one box as appropriate) a practitioner needs to be eligible and
competent. The practitioner must enjoy standing and regard in the profession. The
applicant needs to provide evidence that they are regarded as honest and fair, and that
they are regarded as suited to practice □reconciliation, □negotiation □mediation or
□arbitration (tick only one box as appropriate) by reference to their life, social and
work experience. Please provide this written reference if you have known the
applicant for more than three years demonstrating his/her good character. The
Referees report is to be based on their objective and direct knowledge of the
Applicants competence. Please answer the questions below with care.
As far as legally possible your response will be kept confidential. Please return this
form to:
The Registrar,
Ministry of Constitutional and Legal Affairs,
Government City,
Mtumba Area,
Katiba Street,
P.O. Box 315,
DODOMA, TANZANIA
Email: [email protected]
16
Accreditation)
Name of the referee:……………………………….

Current Occupation (include name of firm if partner or employee):………….
Please, in your reference letter, provide answer to the following:
1. How long have you known the applicant?
2. How have you come to know of the Applicants work?
3. Set out your views of the Applicants competence as a □ Conciliator,
□Negotiator, □Mediator or □Arbitrator (tick only one box as appropriate)?
4. Please indicate by ticking the box against the appropriate number the extent
to which you support the Applicants application for accreditation
□1 = Do not support
□2 = Support with some reservation
□3 = Totally support
Please give brief reasons for your answer
………………………………………………………………………………………
5. Please feel free to make any further comments you wish to in relation to this
application.
Signature: ………………………….. Date:……………………….
17

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Reconciliation, Negotiation, Mediation and Arbitration (Practitioners

UNITED REPUBLIC OF TANZANIA FORM No TAF 1

APPLICATION FOR ACCREDITATION

Application 1. Accreditation Application Kit shall contain:

2. tick the boxes and insert details where relevant.

NOTE: In the statement below tick “Yes” if you agree.

1. I have read and understood my obligations under the Reconciliators, Negotiators,

2. The Code of and Practice for Reconciliators, Negotiators, Mediators and

4. I have no record of serious conviction or impairment that could influence my

5. I have submitted documentary evidence that I am accredited with an existing

6.I have not been disqualified to practice by another professional association

B. TRAINING AND EDUCATION

4. I have completed to a competent standard a written skills assessment of

5. I have worked as a □Reconciliator, □Negotiator, □Mediator or □Arbitrator (tick

D. AGREEMENT AND SIGNATURE:

I, ……………being an applicant for accreditation as a □Reconciliator, □Negotiator,

Signature: ………………… Date:……………………….

Annexure REFERENCE FOR A DISPUTE RESOLUTION PRACTITIONER SEEKING

Name of the referee:……………………………….

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