RECON 2011 TRAINING REGISTRATION FORM -------------------------------------------------------------------------------- Company/Organization: Address: Country: Billing Address: Billing contact email: Fax: Phone: Payment Method: [ ] PayPal [ ] PayPal Credit Card [ ] Certified Cheque [ ] Bank Transfer -------------------------------------------------------------------------------- Training Pricing: 3 Day Training - Before 15 May 2011: 2600$ + tax = 2600$ + 130$ (5% GST) + 232.05 (8.5% QST) = 2962.05 - After 15 May 2011: 3200$ + tax = 3200$ + 160$ (5% GST) + 285.60 (8.5% QST) = 3645.60 2 Day Training - Before 15 May 2011: 2000$ + tax = 2600$ + 100$ (5% GST) + 178.5 (8.5% QST) = 2278.5 - After 15 May 2011: 2300$ + tax = 3200$ + 115$ (5% GST) + 205.27 (8.5% QST) = 2620.27 Conference Pricing: - April 2011: 600 CAD$ 600$ + 30 (5% GST) + 53.55 (8.5% QST) = 683.55 The following discounts are available - 10% for students who attend two training sessions (one before and one after the conference) - 10% for companies with more than 5 students - 15% for companies with more than 10 students -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO -------------------------------------------------------------------------------- First Name: Last Name: Email: I would like to register a seat for the following the training sessions: [ ] Training 1a: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 5-7 2011 [ ] Training 1b: Binary Literacy: Static Reverse Engineering with Rolf Rolles, July 11-13 2011 [ ] Training 2a: Windows Internals for Reverse Engineers with Alex Ionescu, July 5-7 2011 [ ] Training 2b: Windows Internals for Reverse Engineers with Alex Ionescu, July 11-13 2011 [ ] Training 3a: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 5-7 2011 [ ] Training 3b: Bug Hunting and Analysis 0x65 with Aaron Portnoy & Zef Cekaj, July 11-13 2011 [ ] Training 4: Reverse engineering software protections with Nicolas Brulez & Tomislav Pericin, July 6 & 7 2011 [ ] Training 5: The exploit laboratory Advanced Edition with Saumil Shah, July 6 & 7 2011 [ ] Training 6: Introduction to Penetration Testing Web Applications with David Mirza, July 6 & 7 2011 [ ] Training 7: Holistic RFID Hacking with Milosch Meriac, July 6 & 7 2011 I would also like to register a seat at the Recon conference: [ ] YES [ ] NO