Landlord Application

Landlord-Tenant Mediation Program

Please correct the errors described below.

SECTION 1: Landlord Information (to be filled in by Landlord)

SECTION 2: Landlord Attorney Information (to be filled in by Landlord)

SECTION 3: Tenant Information

SECTION 4: Mediator Selection

SECTION 5: Mediator Certifications

Hitting the submit button below will send your completed application to the mediation program. If you have questions about the status of your application please contact us at mediation@vtlandlord.com

Information collected on this form may be transmitted to the State of Vermont (DHCD/AOA) for compliance and monitoring purposes.

Your information will be encrypted.

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