Welcome to Valley Communications Systems
 
Video Conferencing Reservation Request

This form may be used to request a reservation for Valley Communications Video Conferencing facilities. You will be notified with a confirmation of room availability.


Date of Video Conference:  
Start Time:  
End Time:  
Originator Name:  
Originator Email Address:  
Originator Phone Number:  
Contact Name:
(if different than Originator)		  
Contact Name Phone Number:
(if different than Originator)		  
Number of Attendees at Valley:   (Up to 15)
Call Originating From:   Valley Communications Remote End
Connection Type:   ISDN


Remote Information:
    
List the Remote End Site(s):  
First Time Connection with Remote Site?:   Yes  |   No
Remote End Contact:  
Phone Number:  
Equipment:  
Video #1:  
Video #2:  


Equipment Needed at Valley:
    
FAX:   Yes  |  No
Phone Line for Modem:   Yes  |  No
Document Camera:   Yes  |   No
Scan Converter:   Yes  |  No
LAN Connection:   Yes  |  No
Please Add Other Details as Needed:  
Payment Information:
    
Method of Payment:   VISA/MASTERCARD
Cash
Check
Purchase Order
   

 


 
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