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System Design Request

You are here: Home»System Design Request

To request a custom panel designed for your specific needs please fill out this form and a Channel Vision representative will contact you shortly.

Project Information
Project Type:
- Residential Project
- Commercial Project
What does your system require?
- Video
- Telephone
- Data
- Audio
Project Name:*
Project Date:
MM
DD
YYYY
Contact Name:*
FirstLast
Phone*
Email*
Company Name
Address
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Video Distribution
What type of video are you distributing?
- Antenna
- Cable
- Digital Cable
Is the Receiver in a Rack?
- Yes
- No
# of TV Locations:
# of TVs with Cable Receivers:
Are you planning on modulating a source with your Cable/Antenna Feed?
- Yes
- No
Do you have more than one coax feed running to each TV location you would like to modulate to?
- Yes
- No
# of Modulated Sources:
Modulated Source Type?
(i.e. CCTV Camera, Cable Box, DVD Player, Etc.)
Do you have an existing modulator?
- Yes
- No
# of Outputs @ 1'-100'
# of Outputs @ 100'- 200'
# of Outputs @ 200'- 300'
# of Outputs over 300'
Telephone Distribution
Do you need telephone distribution?
- Yes
- No
# of Lines In
# of Drops
Punch Down Type:
- 110 Punch
- RJ-45
Panasonic (KSU) System
- Yes
- No
Data Distribution
Internet Connection Type:
# of Locations / Computers:
Do you want whole house DSL Filter?
- Yes
- No
Do you want Surge Protection?
- Yes
- No
Do you want wireless connectivity?
- Yes
- No
Will you have an access point?
- Yes
- No
Would you like the modem inside the panel?
- Yes, Include a product holder
- No, I don't need a product holder
Audio Distribution
# of Audio Zones:
# of Audio Sources
- 1
- 2
- 3
- 4
Wattage Power Options:
- ABUS
- ARIA - 20W/Channel
Additional Information:
Please provide any additional information that you feel may help with your custom design
Additional Notes:
Related Files:
Upload any related project files or images.

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