Video Conference Site Certification Profile
Today's Date
Jun - 24 th - 2017
SITE Info
Customer ID #
(if known)
Site Name
*
City
*
State (Province)
*
Country
Site Tech Contact
Phone Number
Fax Number
Email Address
*
Equipment Information
Brand of Codec:
Model:
Transmission Speeds
(please check all that apply)
128 / 112
256 / 224
384 / 336
512 / 448
768 / 672
Network Information
(please fill in/ check all that apply)
My Site is ISDN-only
My Site is IP-only (H.323)
My Site has both ISDN
&
IP
ISDN Video Number:
Main Video #
(for bonding)
ISDN Provider:
(specify provider name
)
IP address:
IP Network Provider:
(if known)
IP Connection (type):
DSL
T1 / E1
Other
(specify IP type - if known)
Site Profile Completed By:
( for internal Inconference Office use only)
Word Verification
*
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