[Company Logo Image]        Conference Reservation Form

Video/Audio Conference Reservation Form

Step 1:

Today's Date:
Action:    New  Change  Cancel        

                  If Change/Cancel, provide Meeting ID: 

Step 2:

If Previously registered

Customer ID:

Customer Site ID (if customer has multiple sites):

Customer Billing ID (If different from Customer or Site ID):

Special Offer:

If not previously registered

Company Name: 

Purchase Order Number:

Phone No.: (including area code)

Fax No.:     (including area code)

Credit Card Information:

Holder's Name:

Billing Address:

City:          

State:          Zip:

Country: 

Select Credit Card:

Credit Card No: 

Credit Card Expiration Date:   (Month / Year, MM / YYYY e.g. 01 / 2003)

Step 3:

Conference Info:      

Please allow 10 to 15 minutes connectivity time for your call.

Conference Date:

Start Time: : EST      End Time: : EST

Total number of sites participating in the conference:  

Conference Features:

Switching modes:

Tandberg Duo Video - Share your desktop and video with others in your meetings simultaneously (2 separate screens).

Voice-Activated - The site speaking becomes the site shown onscreen.

Presentation-Mode * - The site presenting becomes the site shown onscreen.

Panoramic Continuous Presence - View Large board rooms or classrooms in a 3-window continuous presence display.

Fixed Presenter  w/Auto Scan * -  The speaker view a scan of all sites in the conference; while other attendees view speaker.

Chair Control (H.243) *

          * Designate Participant:

 

H.320 Platform only:

Continuous Presence - up to 4 Quadrants showing each site onscreen (Designate participants below**) 

Audio Add-on - Audio only calls added to the video conference.    

        Number of Audio Ports: 

Meet and Greet - Start the conference with a special greeting

Data Sharing (T.120) - Share presentation files, legal, or medical documents during the conference

SPEED MATCHING - Allows different speeds to communicate on one call. (i.e. two sites @ 2x64, three sites @ 384 and one site @ 2x56 all participating in one video conference.

 

List all the sites for your conference:  
#

Endpoint
Name/ID#

Select:
 Dial in1– DI
Dial out2– DO

Conference Participant

Name

** Continuous

Presence3

Speed

in

Kbps
1  DI   DO

Fixed VA
2  DI   DO

Fixed VA
3  DI   DO

Fixed VA
4  DI   DO

Fixed VA
5  DI   DO

Fixed VA
6  DI   DO

Fixed VA
7  DI   DO

Fixed VA
8  DI   DO

Fixed VA
9  DI   DO

Fixed VA
10  DI   DO

Fixed VA
Video Mode (Optional)
 QCIF      FCIF
 H.263

1 Dial In: You dial to our conference center                        
2 Dial Out: We dial to your site

3 Fixed Sites and Voice Activated (VA) quadrant: voice-activated quadrant, in Continuous Presence mode,  provides 3 "Fixed Sites" quadrants with the 4th quadrant switching between remaining active speakers)

(For additional sites please add in notes section below)

Step 4:

Options:

Please consult with a Bridging Consultant to see if any of these options can be used with your conference.

CONFERENCING VIDEOTAPE/STORAGE

CASCADING - (Need contact, phone number, company and subsequent port number and conference ID number)

AUDIO CONFERENCE - Audio calls only, no video. 

LIVE OPERATOR ATTENDED

LIVE LANGUAGE TRANSLATOR

        Please specify the desired language translation from/to English:

NOTES OR SPECIAL INSTRUCTIONS:

Favorite charitable organization (must qualify for 501C of the USA tax code):

Name:     

Address:

or Choose from this list: 

(5% of the gross revenues, from this invoice,  will go to the organization you name above)

CANCELLATION POLICY:

After reservation: a charge of $US 25.

Within 24 hours of scheduled conference: 20% of total bridging charges (min $25).