Name :
__________________________________________________________________________________
(last)
(first)
(middle)
Company/Organization
:
_________________________________ Title : __________________________
Address :
________________________________________________________________________________
__________________________________________________________________________________________
Phone :
__________________________________________________________________________________
(daytime)
(evening)
E-mail :
___________________________________________________
Please check
the class
you will prefer to attend.
June 17 - 18,
2013 (9AM - 4PM), May 6th - 7th, 2013 (9AM - 4PM)
How did you
hear about
us ? _________________________________________________________________
I want to get the optional Linux laptop
(additional $500 in the course fee)
Please write a
check or
money order for $1299 ($1799 if Linux laptop is included) 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: _After reviewing your order, we will send you secure GoogleCheckout instructions for payment by credit card__
___________________________________________________________
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_________________________________________