Linux System & Network Administration Bootcamp - 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 level that describes your experience/comfort level with Linux or any other flavor of Unix.

Novice          Beginner           Intermediate           Advanced           Expert

Additional comments:_______________________________________________________________________

Answer the following questions if you are planning to get Linux Certification (optional):

Which certification exam are you planning to take? Please circle the appropriate.

LPI         Red Hat          Linux+          Other (Specify) ______________________________

Additional comments: _______________________________________________________________________

Class Preference

Please check the class you will prefer to attend:

   July 16th - 17th, 2016  (10 AM - 4PM) (Sunnyvale - South Bay)     September 24th - 25th, 2016  (10 AM - 4PM) (Sunnyvale - South Bay)

How did you hear about us? (optional) ___________________________________________________________

Registration Fee

Please write a check or money order for $1,499 payable to "LinuxCertified, Inc." (unless paying by credit card), and send it with this enrollment form to:

LinuxCertified, Inc.
333 Cobalt Way, Suite #107
Sunnyvale, CA 94085

Payment by Credit card: Card number: _After reviewing your order, we will send you secure PayPal instructions for payment by credit card_  

If paying by credit card you can also fax the printed form to(253) 399 7329

Please do notify us via email when sending in the form.

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