Request for Relocation Services (Academic Staff)

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RETURN TO:
Relocation Advisor
Compensation, Job Design & Recruitment
Human Resource Services
2-60 University Terrace
Fax: 780-492-8637
email: [email protected]
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.
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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
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