Linux Device Driver Development - Class Enrollment Form

Contact Information

Name : ___________________________________________________________________________________________________
                               (last)                                      (first)                                           (middle)

Company/Organization : _____________________________________ Title : _______________________________________

Address : _________________________________________________________________________________________________

___________________________________________________________________________________________________________

Phone : ___________________________________________________________________________________________________
                             (daytime)                                                                (evening)

E-mail : ___________________________________________________

Class Preference

Please check the class you will prefer to attend.

  July20 - July 22 , 2009 (San Jose, CA)

How did you hear about us ? _________________________________________________________________

 

Registration Fee

I want to get the optional Linux laptop (additional $700 in the course fee)
Please write a check or money order for $1599 ($2299 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 this form.


I have read and I agree to the Terms and Conditions listed on website of linuxcertified.com

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