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.
May 24 - 25, 2014 (9AM - 4PM) (San Jose, CA), (Live Online)
How did you hear about us ? _________________________________________________________________
Registration Fee
I want to get the optional Linux laptop (additional $500 in the course fee)
Please write a check or money order for $1599 ($1999 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 94085Payment 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_________________________________________