Video Conference Site Certification Profile
         Today's Date   Oct - 23 rd - 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)
 
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