ADASTA NETWORK COURSE REGISTRATION FORM
Minimum Group Participant is 3. For more participant, please fill in new form.
PARTICIPANT 1
Participant 1 Name *
Your answer
Participant 1 E-Mail Address *
Your answer
Participant 1 Contact Number *
Your answer
PARTICIPANT 2
Participant 2 Name
Your answer
Participant 2 Designation
Your answer
Participant 2 E-Mail Address
Your answer
Participant 2 Contact Number
Your answer
PARTICIPANT 3
Participant 3 Name
Your answer
Participant 3 Designation
Your answer
Participant 3 E-Mail Address
Your answer
Participant 3 Contact Number
Your answer
PARTICIPANT 4
Participant 4 Name
Your answer
Participant 4 Designation
Your answer
Participant 4 E-Mail Address
Your answer
Participant 4 Contact Number
Your answer
COMPANY BILLING DETAILS
Organization Name *
Your answer
Organization Type *
Organization Address *
Your answer
Telephone *
Your answer
Fax *
Your answer
E-Mail *
Your answer
Billing Address (If Different from the Above)
Your answer
TRAINING PROGRAMS
Certified IPv6 Network Engineer CNE Silver - 4 Days
Certified IPv6 Network Engineer CNE Gold - 4 Days
Certified IPv6 Security Engineer CSE Silver - 4 Days
Certified IPv6 Security Engineer CSE Gold - 4 Days
REGISTRATION
Please complete and fax/email the registration form to book a seat/seats to the address listed below:

Adasta Network Sdn Bhd:

Unit 10-01, The Vertical II,
Tower B Avenue 3, Bangsar South City,
No: 8 Jalan Kerinchi
59200 Kuala Lumpur, Malaysia.

REGISTRATION FEE
Kindly Send Payment By:
Bank draft / Crossed Cheque / Local order payable to:

ADASTA NETWORK SDN BHD

TERMS & CONDITIONS
Registration will be based on first- come first serve basis.

Registration closes when all seats are filled.

Course fees are payable in advanced at least one week before the start of the course by:
Bank Draft, Money Order or Cheque;
payable to ADASTA NETWORK SDN BHD
PBB 3151505127


Cancellation of the course:

- Adasta Network Sdn Bhd, reserve the right to postpone any program due
to lack of participants or any unforeseen circumstances.
- An attempt will be made to inform the client in advanced.


Withdrawal of participation:
30% of the course fee will be charged if we receive a cancellation request from the client less than 7 working days before a course commence.


Others:

- Participants required to bring their own laptop for the training.
- Contact person for inquiries /registration:
- Tel: 03-2242 0550 (Mr. Naresh) or email to naresh@adastanetwork.asia

CONFIRMATION & ACCEPTANCE
We hereby agree to abide by the terms and conditions and the course schedule as stipulated by ADASTA NETWORK SDN BHD
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