Institution:
School/Department:
Department Contact:
Phone:
Email:
New Hire's Name:
Spouse/Partner's Name:
New Position:
Start date:
Current Home Phone:
Cell Phone:
Current Email:
Current residence address (if known):
Anticipated relocation date:
Standard School/department policy applies: Please check only one below:
Standard School/department policy applies (if on file with HERS)*
Total budget to new hire** (complete Service Authorization Form if restrictions apply)
Services as authorized in the attached (must complete Service Authorization Form)

* HERS must have your School/department’s standard policy on file and it must apply for this new hire's relocation.

Home Sale and/or Purchase; Mortgage Services and Home Builder Discounts will automatically be offered to your employee as appropriate, or as specified by your institutions internal programs or those offered by HERS. All HERS program benefits, including rewards incentives and discounts will apply regardless of whether the institution is paying relocation expenses.

Household Move including: Standard international shipping services include packing materials; full pack and unpack service; door to door transportation and standard customs clearance. Unavoidable additional charges such as duties, taxes, demurrage, per diem, additional port charges or customs examination fees will be brought to your attention if required. Please contact info@HigherEdRelo.com or 800-527-9733 ext. 224, if you need assistance.
Air shipment: note any restrictions if applicable: $ or cu.ft.

Ocean shipment: note any restrictions: $
lift van (~1,000 lbs. net each)
20' container (~7,000 lbs. net)
40' container (~14,000 lbs. net)

Additional Services Authorized:

Crating/Uncrating Service
Yes No

Extra Stops at other than Primary residence
Yes No
(# authorized)

Appliance/Fixture Servicing/disconnect reconnect/adaption
Yes No

Auto Transportation up to
Yes No
vehicle

Conversion costs if applicable (vehicles must be in compliance with US EPA)
Yes No

Bulky items:
Pianos: Yes No
Riding Mowers: Yes No
Big Screen TVs: Yes No
Boats/Canoes: Yes No

Storage up to 30 days
Yes No
Storage beyond 30 days
Yes No up to days*

Post hire Area Familiariztion Tour *
Half day custom tailored tour Full day tour

Cross Cultural Training up to: days or $*

Language Training up to: days or $*

Temporary Housing up to days or $*

Spouse/Partner Career Counseling *
Yes No Up to:

Rental Assistance (schedule and accompany employee on viewing appointments; advise local norms and provide lease negotiation assistance)*
Yes No Up to: Pet Transportation:
Yes No

The following fee based services are available upon request and written authorization. Please click on the links below for additional information. Cost estimates will be provided prior to confirming authorized services.

Settling In Services (assistance with completion of local registration or legal documentation paperwork; area familiarization; residence preparedness extras i.e. maid service, window treatment installation, etc.) *
Yes No

Laboratory Relocation Project Management – Business expense
Yes No

*Taxable benefits which must be reported as additional income to your employee if paid for or reimbursed by your institution. For more information about Tax compliance issues visit www.irs.gov/publications/p521/ar02.html#d0e1353