TRAINING CLASS CHANGE REQUEST FORM - Hacker Halted
TRAINING CLASS CHANGE REQUEST FORM - Hacker Halted
TRAINING CLASS CHANGE REQUEST FORM - Hacker Halted
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<strong>TRAINING</strong> <strong>CLASS</strong> <strong>CHANGE</strong> <strong>REQUEST</strong> <strong>FORM</strong><br />
Please use one form per registrant. This form is for those who have an existing Training registration and<br />
have an existing Confirmation Number. If you do not have a Confirmation Number from your online<br />
registration, you MAY NOT use this form and must register online.<br />
Note that some classes may be sold out and your request will be based on availability.<br />
You must return this form to us no later than September 1, 2011.<br />
To joyce.choo@eccouncil.org or fax to 1.505.212.0828<br />
Please use this form to mark the class you are currently enrolled in as well as the class you are interested<br />
in taking instead. We cannot guarantee your confirmation into any particular class until we have checked<br />
the current enrollment in the new class.<br />
Training Courses Registered Course Requested Change<br />
Certified Ethical <strong>Hacker</strong> (CEH) v7<br />
Certified Security Analyst / Licensed Penetration Tester (ECSA/LPT)<br />
Computer Forensics Hacking Investigator (CHFI)<br />
Certified Incident Handler (ECIH) [2 days]<br />
CAST 611 – Advanced Penetration Testing [3 days]<br />
CAST 612 – Digital Mobile Forensics Deep Dive [3 days]<br />
CAST 613 – Advanced Application Security [3 days]<br />
CAST 614 – Advanced Network Defense [3 days]<br />
CAST 615 – Cryptography Deep Dive [3 days]<br />
Advanced VoIP: Securing UC Networks<br />
Hacking Web 2.0 Applications (Securing Ajax, RIA & SOA) [2 days]<br />
Wireless & Bluetooth Hacking 101 [2 days]<br />
SAP Security In Depth [2 days]<br />
CompTIA Security+ [3 days]<br />
Certified Information Systems Security Professional (CISSP)<br />
Certified Secure Software Lifecycle Professional (CSSLP)<br />
Crimeware Attribution [2 days]
HACKER HALTED USA 2011 PAYMENT <strong>FORM</strong><br />
To register complete the form below as well as the Add a Class Form and return it to:<br />
Email: joyce.choo@eccouncil.org or Fax +1 505 212 0828<br />
Please complete this form in its entirety and legibly.<br />
Registrant Name<br />
_______________________________________________________________________________<br />
Confirmation Number<br />
_______________________________________________________________________________<br />
□ I understand that my seat in a training class is not confirmed until payment has been received. <strong>Hacker</strong> <strong>Halted</strong><br />
reserves the right to cancel my Training registration should I fail to provide payment in full within 7 days of<br />
submitting this form.<br />
Method of Payment<br />
□ I will be paying by Google Checkout<br />
□ I will be paying by Wire Transfer<br />
□ Please charge my credit card, for the amount indicated in the credit card authorization form. I understand the<br />
credit card charge will show up as <strong>Hacker</strong> <strong>Halted</strong> USA 2011 and will be in US Dollars.