AV Needs Analysis Form

Full Name:*

Organization:*

Title:

Address:*

City:*

State:* AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip:*

Telephone :*

Email:*

Confirm Email:*

How do you prefer to be contacted?

--Please Select-- Email Telephone

What type of project are you planning? Check all that apply:

Boardroom/Conference Room

Auditorium

Classroom or Training Room

Council Chambers

Medical or Operating

Arena or Stadiums

Entertainment Venue

Command/Control

Other :

Is the project:

A renovation with new technology

An addition to existing technology

New construction

How often will the room be in use?

24/7 Operation
More than 20 hours a week
Between 10 - 20 hours a week
Less than 10 hours a week

Which of the following media or tools might be required by the presenters?

Computer Presentation

Video

DVD

Document Cameras

Videoconferencing

Audioconferencing

Electronic Whiteboard

Other:

Would you like to include a dedicated computer for this system?

--Please Select-- Yes No

Will this project require a podium?

--Please Select-- Yes No

Will you require a control system?

--Please Select-- Yes No

Is there a storage space to house the equipment?

--Please Select-- Yes No

How will seating be arranged?

How much do you anticipate spending on the design, integration, equipment, and installation of this audiovisual system?

--Please Select-- $10,000 or less $10,000 - 20,000 $20,000 - 100,000 $100,000 - 150,000 $150,000 - 250,000 $250,000 - 500,000 $500,000 or more

What is your timeframe for this project?

--Please Select-- 90 days 6 months More than 6 months

Additional Comments:

Note: Fields marked with an * are required.