On-Line Consultation Request Form

Please fill in as much information as you can and we will respond as soon as possible to your request.

Contact information:

Title  
First Name  
Last Name  
Organization  
Work Phone   (999) 999-9999
Email  

Purpose of the consultation:

 

---------------------------------------------------------------------------------------------------------------------

Which type of renovation is this:

 New Installation        Upgrade

---------------------------------------------------------------------------------------------------------------------

Will the technology need technical support:

 Yes                       No

---------------------------------------------------------------------------------------------------------------------

Which type of room are you planning:

Auditorium            Classroom            Conference             Control             Training

---------------------------------------------------------------------------------------------------------------------

        Which technology will be needed in this room:    

Computer Presentation          Document Camera   VCR VHS/DVD combo
Videoconferencing   LCD Television   Multimedia LCD  Projector
                                            Projection Screen:    Remote Control:

Electric 

  Stationary Button Pad  

Non-electric

   Graphical Touch Screen  

---------------------------------------------------------------------------------------------------------------------

What is the perspective budget for this project:

  Less than $5,000                   $5,000 - $10,000                   $10,000 - $20,000        

  $20,000 - $30,000                $30,000 - $40,000                 $40,000 - $50,000        

  Greater than $50,000

---------------------------------------------------------------------------------------------------------------------

What will be the technical experience level of the presenter:

Very Experienced               Intermediate               Novice

---------------------------------------------------------------------------------------------------------------------

What type of user will be utilizing this technology:

Executives               Instructors              Staff               Students

---------------------------------------------------------------------------------------------------------------------

       

Classroom Technology Services Manger..
Copyright © 2007 [UMKC IS - Classroom Technology Services]. All rights reserved.
Revised: 09/30/11