Wikipedia:Requests for mediation/Top/Sample

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Filed:,   (UTC)

Involved parties

 * , filing party


 * : you must serve all of these editors with notifications. See here for instructions.

Other steps in dispute resolution that have been attempted

 * Example link 1.
 * Example link 2.


 * : Please ensure you have fully read this guide before filing.''

Issues to be mediated

 * The party filing this request uses this section to list the issues for mediation. Other parties can list additional issues in the section below.


 * Issue 1.
 * Issue 2.

Additional issues to be mediated

 * Other parties can use this section to list any others issues they wish to include in the mediation. Please do not modify or remove any other party's listing. Please sign all additions to this section if there are more than two parties involved in this case.


 * Additional issue 1.
 * Additional issue 2.

Parties' agreement to mediate

 * All parties should sign below, indicating that they agree to mediate the issue. If any party fails to sign within seven days, or if a party indicates they do not agree, then the mediation will be rejected. Only "Agree" or "Disagree" and signatures should appear here; any comments will be removed, but can be made at the talk page.


 * 1) Agree.

Decision of the Mediation Committee

 * A member of the Mediation Committee will indicate acceptance/rejection/other relevant notes in this section. Non-Committee members should not edit this section ; all comments should go on the talk page, unless a party is specifically requested to reply here by a Committee member.