Relocation Partner Qualification Form
Please complete the following information:
Primary Information
History
FoundedFormer Name(s) Affiliation(Van Line, etc) Parent Company Business Type Select from list Corporation Proprietorship Partnership LLC Other Are you a minority/disabled veteran owned business? No Asian African American Disabled Veteran Filipino Hispanic Native American Polynesian Are you a woman owned business? No Yes 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