Client Profile Needs Assessment 2003

By providing us with the following information we will be better able to assist you in either your Look-See /Orientation or Homefinding Program which meets your requirements. This will enable you to have a more pleasant and productive relocation experience. Information that does not pertain to your situation, indicate as N/A (Not Applicable)

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International Assignee Information Full name:  Current Home Address: Date of Birth: Citizenship:  Home Tel:  Home fax: Mobile:  . . Work Tel Work Fax.  Email address:  Moving from: Language(s) preferred:  Destination Data Company name:  Division:  New Position: Work start date:  Length of Assignment:   Destination City: Flight/ Hotel Information Date: Arrival Time:  Airline:  Flight number: From: Will you need airport pick up?:  Choose one Yes No Hotel where you will be staying:  Family Profile Spouse/Partner Information Name:  Date of Birth: Citizenship: Language(s) preferred:  Occupation: Will spouse / partner be pursuing employment?  Choose one Yes No Will spouse / partner need employment assistance? Choose one Yes No   Children’s Information Name: Date of Birth: Male/Female: Grade:   School´s information Day care assistance School search Universities Information What kind of school are you looking for? Please comment:  Do any of your dependents have any school requirements, special needs, interests, sports, etc.  Would you like Information on adult education (art courses, cooking classes, languages, etc.). Please Specify:    Look – See / Orientation Trip Has the assignment been accepted: Choose one Yes No Have you being in México before? Choose one Yes No Who will accompany in your Look see/Orientation Trip? How long will you be staying for your home search?   Housing Information Intended occupancy date:  Monthly rental allowance:  Length of lease term:  Bedrooms required:  Bathrooms required:  Other requirements:  . Furnished     Unfurnished   Preferred Housing Apartment House in Gated Community / Townhouse Single Family Home Which items are important in your house/ apartment Comment:   Rental Furniture Do you need assistance with furniture rental  Choose one Yes No How many months?    Pets Wil you be bringing a pet?  Choose one Yes No If Yes, do you know that bringing a pet will reduce the number/ type of properties that can be shown to you? Choose one Yes No Settling In Services Please indicate which of the following services you required Airport reception Buy Furniture Medical/Dental referrals Postal Services Adult education Child care Places of worship Auto Purchase / lease Insurance Sports information Social Clubs Local information Children´s activities Food & shopping       Additional requirements:   Security Code:

Kathy M. Gibler
Monterrey ! Quality Relocation Services
Monterrey, Mexico
011-52(81) 8309-6670
Local Dial
044-81-8309-6670
Fax
011-52(81) 8356-6992
Local Dial 8356-6992