Conference Date Date Start Time
Specify AM or PM
Duration Scheduling Party Contact Name * Company * Contact Email *
Please enter only one email address. If you would like an additional email address to receive a confirmation email, please include that address in the Special Requirements section at the bottom of this form.
Address Contact Phone * Fax Billing Party Billing Name Billing Email Confirm Billing Email *
Billing Address Billing Phone Fax
List each location you will be renting from Gramann Reporting, Ltd.:
Location 1 City - Location 1 Number of Attendees Participant Name - Location 1 Participant Phone - Location 1 Location 2 City - Location 2 Number of Attendees Participant Name - Location 2 Participant Phone - Location 2 Location 3 City - Location 2 Number of Attendees Participant Name - Location 3 Participant Phone - Location 3
Select Remote Sites
Remote Site 1 City Room Telephone/Contact Equipment/Model ISDN/IP Dial-up Access Number Remote Site 2 City Room Telephone/Contact Equipment/Model ISDN/IP Dial-up Access Number Remote Site 3 City Room Telephone/Contact Equipment/Model ISDN/IP Dial-up Access Number Which Remote Site will initiate the call? Remote Site 1 Remote Site 2 Remote Site 3 Specifications Speed of Conference: Special Requirements
Please enter any special requirements such as videotape, document camera, laptop connection, catering, etc.
Projected Cost: Costs are pro-rated based on information provided by scheduling party and are subject to change based on changes made prior to or at the time of the conference.
Reservation Fee: N/C
Room Rental Rate: $185 per hour
ISDN Tel. Fees: 80$ per hour if in U.S. If outside the US, please enter country below Terms and Conditions TERMS AND CONDITIONS: 1. Reservation of rented room will not be held until signed reservation form is received. 2. Reservation fees may be applicable at some rented locations. If applicable, reservation fee payment must accompany signed reservation form. 3. Room rentals and ISDN long distance fees are based on hourly fees, minimum one hour and billed in half-hour increments thereafter. 4. Room rental may not be reduced by unused time and additional use beyond the scheduled time may be restricted. 5. Cancellation fees: One hour of room rental will be assessed if cancelled within 24 hours of conference. If you would like to cancel a Videoconference via email, we will confirm receipt of the email cancellation request within 1 hour during normal business hours. Please contact Gramann Reporting by telephone if you do not receive a response or you will be held responsible for cancellation fees. 6. Your credit card will be charged at the conclusion of the videoconference, unless other arrangements have been made. 7. The scheduling party is responsible for all fees incurred on behalf of Gramann Reporting in instances where Gramann Reporting schedules additional sites or services for the below signed. This includes agreement to the cancellation policies of all videoconferencing sites scheduled on your behalf. 8. Gramann Reporting, Ltd. and its affiliated rental sites are not responsible for delays, postponements, failure of video conferencing technology or cancellations due to unforeseen circumstances and in no way are liable for any loss of use, lost profits, consequential or any other damages. In no event shall any liability exceed the amount of the room rental fee. Name Authorizing Payment Date