* 1. Name (first and last):

* 2. Email Address:

* 3. Phone Number:

* 4. Twitter Handle (if none, write n/a):

* 5. Course Title:
-LISTED ON BLACK HAT EVENT WEBSITE

* 6. Presented by (name or company name):
-LISTED ON BLACK HAT EVENT WEBSITE

* 7. Name on Contract (payment made to--must match W-8Ben or W-9):

* 8. Requested Payment (per student amount):

* 9. Length of Course:

* 10. Class Max (# of students):

* 11. Absolute Class Max (# of students if your class reaches max):

* 12. What Category/ies Does Your Course Fall Under?

* 13. SHORT Course Abstract (2-4 sentences):
-LISTED ON BLACK HAT EVENT WEBSITE

* 14. FULL Course Abstract:
-LISTED ON BLACK HAT EVENT WEBSITE

* 15. Who Should Take This Course:
-LISTED ON BLACK HAT EVENT WEBSITE

* 16. Student Requirements:
-LISTED ON BLACK HAT EVENT WEBSITE

* 17. What Students Should Bring:
-LISTED ON BLACK HAT EVENT WEBSITE

* 18. What Students Will Be Provided With:
-LISTED ON BLACK HAT EVENT WEBSITE

* 19. Trainer Names & Bios:
-LISTED ON BLACK HAT EVENT WEBSITE

* 20. Course Materials:

* 21. Do You Have Materials and/or Equipment That Must be Shipped to the Venue?

* 22. What Kind of Equipment Do You Need in Your Classroom (BH to provide)?

  0 1 2
# of Screens
# of Microphones

* 23. What Kind of Internet Do You Need in Your Classroom (BH to provide)?

* 24. Do You Have a Specific Classroom Set-Up?

25. Are you interested in teaching THIS EXACT course at Black Hat Europe 2014?
-Trainings run October 14-15, 2014
-2 day courses only

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