RETURN TO: Relocation Advisor Compensation, Job Design & Recruitment Human Resource Services 2-60 University Terrace Fax: 780-492-8637 email: relocationservices@hrs.ualberta.ca REQUEST FOR RELOCATION SERVICES Allowable travel and relocation expenses are set out in the Moving Expenses and Relocation Benefits for Academic Staff Procedure Forward completed form and a copy of the signed Appointment Contract to Relocation Advisor, CJD & R. To advance to the next field, press the TAB key. To go back to a previous field, press the SHIFT key and TAB key simultaneously. APPOINTMENT INFORM ATION HIRING UNIT APPOINTMENT TYPE Continuing Academic (APO, Faculty, FSO, Librarian) Operating or TITLE Other (e.g. Trust Academic): Contingent FIRST NAME INITIALS START DATE OF APPOINTMENT LAST NAME CITIZENSHIP(s) Canadian Other Enter Citizenship if not Canadian RELOCATION INFORMATION ADDRESS OF CURRENT PRIMARY RESIDENCE CITY PROVINCE / STATE PHONE (HOME) PHONE (WORK) POSTAL CODE / ZIP CODE PHONE (CELL) EMAIL ADDRESS HOUSEHOLD MOVING EXPENSES TO BE CHARGED TO Central Funds (only available for non-contingent continuing academics) Hiring unit* Trust research grant* Other (specify): *Relocation Services will review the invoice from the moving company and forward to the hiring unit for payment authorization. Expense Reports are keyed directly into PeopleSoft. INDICATE ANY ADDITIONAL NEGOTIATED RELOCATION COSTS THAT WERE SET OUT IN THE CONTRACT: (e.g. additional weight allowance, additional storage costs, additional house hunting trip). DEPARTMENT AUTHORIZATION PRINTED NAME SIGNATURE DATE The personal information on this form is collected for the purpose of arranging relocation services under the authority of Section 33c of the Alberta Freedom of Information and Protection of Privacy Act (FOIPP) and will be protected under Part 2 of that Act. Certain information will be disclosed to administrative units of the University and preferred moving companies on retainer with the University. For further information regarding the collection, use and disclosure of personal information, contact Human Resource Services at 780-4924555.. 10/02/2016