Relocation Coordinates Inc.

Services Authorized By

From (Company Name):

Requested By:

Title:

Corporate Address:

E-mail Address of Person Above:

Company Fax Number:

Company Phone Number:

Services Authorized

Relocation Type:

Employee Status:

New Hire Start Date:

I authorize RCI to contact the employee and perform the following service:
	Candidate / Pre-Transfer Services (service for employee status types A, B, D) - Needs Assessment and Personalized Information Package sent prior to arrival. Realtor and Lender consultation as appropriate - Orientation: Area counseling, Map work, Housing market overview, Audio visual presentation, Data & information sheets, Area maps, Community & School information / publications, Personalized Research for example: Higher Education, Special Education, Daycare Facilities - Community familiarization / sample housing - Cost of Living Information - Specialized research as required, Post interview follow-up & mailings as required, Feedback to corporation / recruiter
	New Hire/Transfer (order this for status types C or E) These services are performed in conjunction with Candidate / Pre-Transfer Services - Continuing Orientation and counseling for partner/family, personalized Settling in Package (DMV, Utility, Voter Registration, Change of Address and Community services information) - Assistance with Temporary housing, Permanent housing search, Realtor referrals, Mortgage lender referrals, Moving & Storage counseling/booking
	Introductory Services Phone & Mail Service only at this time - Long distance counseling on communities, housing, education, cost of living - Mail-out of appropriate information

Employee Name:

Job Title:

Partner Name:

Current Home Address:

City:

State:

Zip:

Country:

Current Work Phone Number:

Be Discreet with Messages?

Fax Number:

Mobile Number:

Current Home Phone Number:

E-mail Address:

Alternate E-mail Address:

Destination City:

Destination Country:

Arrival Date:

Arrival Time:

Interview Date:

Interview Time:

Departure Date:

Departure Time:

Hotel Name:

Hotel Phone Number:

Alternate Phone Number:

Employee is traveling:

Please list specific relocation incentives, issues, special instructions, airline info, etc…