Relocation Partner Qualification Form

Please complete the following information:

Primary Information

Company Name 
Company Address  
City  
US State ZIP
Country
Company Website  
Name of Local Contact
Title 
Phone # 
E-mail address

History

FoundedFormer Name(s)
Affiliation(Van Line, etc)             
Parent Company                         
Business Type
Are you a minority/disabled veteran owned business?

Are you a woman owned business?
Number of Employees             
Are your employees unionized?
Insurance Coverage                 
Gross Sales:
Current Year   Previous Year

References
Company                    Contact Name       Phone # &/or e-mail


Services and Operational Capabilities
Market Area that you serve (List Cities, Counties, States or Countries if applicable)
 
What cities do you have offices?

    General Freight Transportation
    Complete Transportation of Household Goods
           Loading Services
           Unloading Services
           Other Services (ie. Packing Services, etc)        
    Air Freight
    Temporary Housing (Includes those leasing their own residence)
    Area Tours
    Real Estate Agent
        Relocation Department (of a Real Estate Agency)
        Rental Assistance (Assisting employees in finding housing)
    Other:

How did you hear about us?

Authorized Name   Date