Relocation
Date:
Number
of Employees Relocating:
Will
a representative visit the area pior relocation?
yes no
Prior
Visit Date:
Business
Name:
Type
of Business:
Your
Profession:
First
Name:
Last
Name:
Business
Address:
State/Province/Shire:
Country:
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahama
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda Bhutan Bolivia Bosnia and Herzegovina
Botswana Bouvet Island Brazil British Indian Ocean
Territory British
Virgin Islands Brunei
Darussalam Bulgaria
Burkina Faso Burundi Cambodia Cameroon Canada Cape
Verde Cayman
Islands Central
African Republic Chad Chile China
Christmas Island Cocos (Keeling) Islands
Colombia Comoros Congo
Cook Iislands Costa Rica Cote D'ivoire (Ivory
Coast) Croatia Cuba Cyprus
Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt
El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands
(Malvinas) Faroe
Islands Fiji Finland France French
Guiana French
Polynesia French Southern
Territories Gabon Gambia Georgia Germany Ghana
Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti
Heard & McDonald
Islands Honduras Hong Kong Hungary Iceland India
Indonesia Iraq Ireland
Islamic Republic of
Iran Israel Italy Jamaica
Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic
People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic
Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya
Liechtenstein Lithuania Luxembourg Macau Madagascar Malawi Malaysia Maldives Mali
Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova, Republic of Monaco Mongolia Monserrat Morocco Mozambique Myanmar Namibia Nauru
Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria
Niue Norfolk Island Northern Mariana Islands
Norway Oman Pakistan
Palau Panama Papua New Guinea Paraguay Peru
Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion
Romania Russian Federation Rwanda Saint
Lucia Samoa San Marino Sao Tome & Principe
Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South
Africa South Georgia
and the South Sandwich Islands Spain Sri
Lanka St. Helena
St. Kitts and Nevis
St. Pierre &
Miquelon St. Vincent & the
Grenadines Sudan Suriname Svalbard & Jan Mayen
Islands Swaziland
Sweden Switzerland Syrian Arab Republic Taiwan, Province of
China Tajikistan
Tanzania, United
Republic of Thailand
Togo Tokelau Tonga
Trinidad &
Tobago Tunisia Turkey Turkmenistan Turks & Caicos
Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (Great
Britain) United States Minor
Outlying Islands United States of America
United States Virgin
Islands Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Wallis & Futuna
Islands Western
Sahara Yemen Yugoslavia Zaire Zambia
Zimbabwe
Contact
Number:
E-mail
Address: *
* * * *
* * * * * * * * * PROPERTY REQUEST
Property
Desire:
Sq
Footage Range:
Number
of Floors:
Number
of Offices:
Number
of Work Station:
Conference
Room:
yes no
Kitchen/Lunch
Area:
yes no
Photocopy
Room:
yes no
Reception
Area:
yes no
Safe
Space:
yes no
Safe
Space Sq Ft Range:
Storage
Area:
yes no
Storage
Area Sq Ft Range:
* * * *
* * * * * * * * * STAFFING REQUEST
Number
of Employee you would like to hire:
Positions
needed:
* * * *
* * * * * * * * * ADDISIONAL REQUEST
Cash
Rester System:
yes no
Computer
System:
yes no
Florist:
yes no
Reception
Area Weekly:
yes no
Large
Plants:
yes no
Furniture:
yes no
Furniture
Details:
Internet
Provider:
yes no
Kitchen/Lunch
Supplies:
yes no
Office
Supplies:
yes no
Security
System:
yes no
Number
of Lines :
Telecommunication:
yes no
Cell
Phones/Moble:
yes no
Washroom
Supplies:
yes no
* * * *
* * * * * * * * * * * * * GRAND OPENING REQUEST
Would
you like to have a Grand Opening? :
yes no
Grand
opening Date:
Grand
opening Details:
*
Required
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