Video Conference Site Certification Profile
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Site Information:
Customer ID:
City:
Site Name:
Country:
Phone Number:
Province:
Fax Number:
E-mail Address:
Equipment information:
Brand of Codec:
Model:
Transmission Speeds (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 Network Provider: (if known)
IP Connection (type): DSL
T1 / E1
Other (specify IP type - if known)
Site Profile Completed By:
