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Customer information form

Customer information
Code Your e-mail address
Location information
Company name:
Address: Zip Code:
City: Country:
General Phone number: General Fax number:
Technical contact Network contact
Name: Name:
Phone number: Phone number:
E-mail address: E-mail address:
Building access Installation & training
Is parking space available: What is your preferred installation date:
On which floor is the installation planned: How many people will attend to the training
Is there an elevator available: Is an Secure ID needed:
Conference room
Room number or name: 120V or 230V voltage:
Dimensions of the room: Wall material (concrete, wood):
Can the windows be blacked out: Wall thickness:
What kind of lighting is installed: Is there a beamer to install the Video Conference System on, if so, which
Is there a double power socket available: brand and type:
Infrastructure
IP Settings ISDN Settings
IP Assignment:
Are ISDN lines available (if applicable) and what numbers:
IP Ethernet speed:
ISDN lines need to meet these specifications:
  • Euro ISDN
  • Not bundled to one group
  • Network terminators need to be within 25 meters from VC equipment
  • B channels have to support data
  • The lines have to be configured Point to Multipoint
Static IP address:
Static IP subnet mask:
Static IP Gateway
Quality of Service:
H323 ID settings:
H323 ID:
E.164 Alias SIP settings
Gatekeeper IP address: SIP URI:
NAT: SIP Registrar:
NAT address: Username:
  Password:
System name:
 
What kind of phonebook needs to be uploaded into the system: Remarks: