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World Trade Centre, 14th Floor
Jl. Jend. Sudirman Kav. 29-31
Jakarta, 12920

Tel: 62 21 521 1400
Fax: 62 21 520 6222
Orientation Need Analysis

Personal Information
Family Name *
First Name *
Home Country / Nationality
Personal Contact Details
E-Mail Address *
Mobile Phone (with country and area code)
Telephone Number (with country and area code) *
Fax Number (with country and area code)
Office Contact Details
Company Name
Relocation Coordinator, if any
Office Telephone Number
Office Fax Number
E-Mail Address
Timing / Arrival in Jakarta
When is your expected arrival date and flight number?
dd-mmm-yy, e.g: 13-Jul-09
Flight Number :
Have you already accepted this posting or is this a ¨Look and See¨ visit? Already accepted
A ¨Look and See¨ visit
If accepted, when would you prefer to have your Orientation?
dd-mmm-yy, e.g: 13-Jul-09
Temporary Residence / Hotel Contact Information
Overseas Living Experience / Language Capability
Have you lived overseas before? Yes   No
If so, in which countries?
Where are you transferring from?
Do you have proficiency in English? Yes   No
If not, please specify the language you prefer for the orientation program
Spouse / Children
Do you have a spouse who will be moving to Jakarta with you? Yes   No
If yes, what is his/her name?
Does your spouse need employment information? Yes   No
Do you have children who will be moving to Jakarta with you? Yes   No
If yes, please list their details below:
Children's Name Date of Birth

  Grade
 
  Special School Needs
 
Do you require school & pre-school appointments / inspections? Yes   No
Which school system(s) do you prefer?
Jakarta International School (JIS)
British International School
Australian International School
ACG International School
Deutsche Internationale Schule
Gandhi Memorial International School
Jakarta International Korean School
Jakarta Japanese School
Lycée Internationale Française
Nederlandse Internationale School
New Zealand International School
North Jakarta International School
Singapore International School
Other
If you or any of your family members have a medical condition that requires a specialist or take regular medication and you need further information, please list the details below.
Medical Condition Specialist / Treatment Required
  Medication Required
 
Leisure and Entertainment
Do you require information on religious institutions? Yes   No
If yes, please state your preference.
Please indicate if you would like further information about the availability of any of the following activities.
Art/Craft Lessons Language Courses
Cultural Study Groups Musical Lessons
Dance Groups/Lessons Scuba Diving
Fitness Centers Swim Clubs
Golf Clubs Tennis Clubs
Horse Riding Theater Groups
Please list any other activities that interest you and your family
Do you intend to bring your family pet(s) with you? Yes   No
If yes, what is the type of your pet(s)?
Other
Please list any additional information that you require pertaining to your intended move to Jakarta including such items as cost of living, product availability and prices or banking information.
Would you like information concerning any of the other services provided by Colliers International:
Home Search
Pre-lease Inspection
Furniture and Appliance Leasing
Facility Management
Other  
 
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