Adirondack Area Network Video Conferencing

Non-Member Registration Form
Sections marked with an (*) are rquired.
Press when finished.

Contact Information

* Company Name:

* Mailing Address:

* Phone Number xxx-xxx-xxxx:

Fax Number:

E-Mail Address:

Are Your A Service Provider?

Yes

No

Billing Information

Billing Account Name:

Billing Address:

Billing Contact:

Phone Number:


Site Connection Information

What site will you be connecting to?

Connecting to?


Dial-Up Information

Video System Dial up Numbers (VSN’s)

* VSN-1:

VSN-2:


Technical Contact Information

Video Site Specialist:

Phone Number:

Fax Number:

* Technical Contact:

* Phone Number:

E-Mail Address:

Video Room Phone Number:


Network Information

Transmission Speeds:

2x56 (Dual 56 kbps)

112 (Dual 56 kbps Bonded)

2x64 (Dual 64kbps)

128 (Dual 64 kbps Bonded)

336 (6x56 kbps)

384 (6x64 kbps)

Other

Video Transmission Carrier:

Sprint

AT&T

MCI/Worldcom

Verizon

Other

Network Access:

Dedicated

Switched

T1

LEC Switched 56

ISDN BRI

ISDN PRI

H.323/Analog

Video Equipment Information

Provide the following where applicable:

Equipment Manufacturer:
Equipment Model:
Video Algorithm:
Line Interface:

Inverse Multiplexer

Video CODEC

Access to AAN (Adirondack Area Network) Video Conferencing requires site registration and a quality assurance test at individual video speeds and algorithms. The quality assurance test is to ensure proper operation with AAN’s connectivity services.

Please register and schedule test call a minimum of 48 hours prior to program start date/time.