Registration For the course: Advanced Django provided by: Python Academy UG (haftungsbeschränkt) & Co. KG Zur Schule 20 04158 Leipzig, Germany per Fax +49 341 520 4495 Course date: Course number: October 18 - 20, 2012 IDE012012 Course price per participant 900,- € netto plus 19% VAT 1071,- € brutto including 19% VAT Company: First name: Last name: Street: Zip/City: Country: Telephone-number: E-mail-address: Ust-ID-Nr. / VAT-ID-No: (if applicable) Names of participants: 1 2 3 4 Hereby I/we declare that I/we read the terms and condition of Python Academy UG (haftungsbeschränkt) & Co. KG. We agree with the terms and conditions therein. Remarks: Date, Signature, Company stamp