Corporate Relocations - Relocation Simplified

Needs Assesment Form

Please complete the sections that are relevant to your needs. You may click on each link to make sure you have entered everything correctly. Once you have completed filling in your information click Submit to send through your entire form.

	Personal Data - Employee		Housing Information - Host Country (New Location City)
	Personal Data - Spouse / Partner		Temporary Living Needs
	Assignment Details		Lifestyle Living Needs
	Personal Data - Children		Community Familiarization
	Housing Information - Home Country

Personal Data - Employee

Name

Surname

Employer

Date of Birth

Country of Birth

Country of Citizenship

Country of Passport Issue

Passport No

Passport Expiration

Current Home Address

Street

City

Country

Postal Code

Business Email

Personal Email

Phone Numbers

Business (country code)

Number

Mobile (country code)

Number

Personal (country code)

Number

Is your relocation confidential?

YesNo

Languages Spoken

Previous International Assignment

Housing Information - Host Country (New Location City)

Are you intending to rent Are you intending to purchase

RENTING

Housing Budget

per month

per annum

Does the above housing budget include utilities?	YesNo
Name on lease (yours or employer's)
Preferred start date on lease
Length of lease
Deposit will be paid by
Rent will be paid by

PURCHASING

Please provide an indication of how much you are willing to spend?

Lower Limit

Upper Limit

Type of Housing preferred (pending availability)

UnfurnishedFurnished

Type of Housing	Facilities	Other Considerations
Home in gated/security complex	No. bedrooms	Security
Apartment	No. bathrooms	Max commute time
Urban setting	No. living rooms	Proximity to school
Suburban setting	No. garages	Yard size/space
Free standing home	Study	Other (please list)
	Heating / AC	Other (please list)
	Swimming pool	Other (please list)
	Domestic staff accommodation	Other (please list)

Are you particularly interested in any area or neighborhood, if known to you?
What pre-arrival information would be helpful to you to assist with your home search?

Personal Data - Spouse / Partner

Name
Surname
Employer
Date of Birth		Country of Birth
Country of Citizenship		Country of Passport Issue
Passport No		Passport Expiration

Current Home Address
Street		City
Country		Postal Code
Business Email
Personal Email

Phone Numbers
Business (country code)		Number
Mobile (country code)		Number
Personal (country code)		Number

Languages Spoken

Temporary Living Needs

Will you require assistance finding accommodation before you move into your permanent accommodation

YesNo

If shipping household goods, approximate shipping date from home country

If shipping, please provide name of shipping company

Name

Contact

Type of temporary housing preferred (pending availability)

Hotel		Hotel apartment with kitchenette
Apartment (fully furnished)		No. bedrooms
No. bathrooms

Assignment Details

Assignment details
Start date
Length
Transferring to (city)
New title

Do you immigration (visa or work permit) assistance?	YesNo
Will your family be accompanying you on pre-assignment visit?	YesNo

Host country manager or HR contact name
Office telephone
e-Mail

Lifestyle Living Needs

Favorite social activities
Favorte sports / hobbies
Preferred forms of entertainment
Spouse/partner work, volunteer, study opportunities during assignment
Any special health concerns
Any special religious needs or concerns

Personal Data - Children accompanying parents on assignment

	Name of child	Gender	Date of birth	Grade
1.		MaleFemale
2.		MaleFemale
3.		MaleFemale

Home Language(s)

If you require school search assistance, please indicate your preferences below
International SchoolPrivate SchoolState SchoolCo-Ed (Mixed girls & boys) Boys / Girls onlyPre-SchoolDay CareNanny / Au pair

Do you have any preference regarding religious affiliation of schools?

List any schools you have heard of that you may be interested in

Please list sporting and or extra mural activity important to your child / children

Special needs / concerns with children's relocation

What information would be helpful to you to assist with your child / children's assimilation into South Africa?

Are there any other family members relocating with you? If YES please specify

YesNo

Do you plan to bring a pet or pets
Do you require assistance or information
If YES please indicate number and type

Community Familiarization

To assist us in tailoring your programme to your specific requirements, please indicate if you need familiarization with or information on the following
DescriptionDriving information, licenses, etc BankingInsurance SecurityTelecommunications / postal service Satellite TVLanguage training Health care facilities and emergency careShopping facilities (grocery,appliance & furniture) Health clubsSports clubs Recreational leisure optionsChildren's activities Domestic helpChild care services Expatriate support groupsCross cultural training / customs / local culture
Religious worship (please specify)

Are there any other questions or concerns you have, or information we should know to assist with your relocation?

Housing Information - Home Country

Single Family DwellingUrban SettingApartmentSuburban Setting CondominiumSwimming PoolAC

Distance from work	miles	kms
Distance from school	miles	kms
Commute time
Yard size
Do you use public Transport	YesNo
Selling Property	YesNo

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