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Linux Fundamentals -
Class Enrollment Form
Contact Information
Name :
_____________________________________________________________________________________________
(last)
(first)
(middle)
Company/Organization
:
______________________________________ Title :
_________________________________
Address :
____________________________________________________________________________________________
______________________________________________________________________________________________________
Phone :
______________________________________________________________________________________________
(daytime)
(mobile/evening)
E-mail :
______________________________________________________
Linux
Background
Please circle
the
appropriate that describes your experience/comfort level with Linux or
any other flavor of Unix.
Novice
Beginner
Intermediate
Advanced
Additional comments:_______________________________________________________________________
Class
Preference
Please check
the class
you will prefer to attend.
 June 12 - 13, 2008 (San Francisco - South Bay)
How did you
hear about
us ? _________________________________________________________________
Registration Fee
Please write a
check or
money order for $1,299 ($700 without the laptop) payable to "LinuxCertified, Inc." (unless paying
by credit card), and send it with this enrollment form to:
LinuxCertified,
Inc.
349 Cobalt Way, Suite 304
Sunnyvale, CA 94085
Payment by
Credit card:
Card number: ___________________________________
Expiration: ________________
Card type (circle one): Visa Mastercard
American Express
Name on the Credit card: ____________________________________
CID/CVV2 number:_____________(4 digit number
on top of AMEX or 3 digit number at the end of signature
panel of Visa/Master Card/Discover)
Signature: ______________________ Date: ________________
Credit Card Billing address:____________________________________
___________________________________________________________
If paying by credit card, you can also fax the form to (425) 732-7143
Please do notify us via email when sending the form.
I have read and I agree to the Terms and Conditions listed on website of
linuxcertified.com
Signature_________________________________________
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