Ceh Application

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Exam Eligibility Application Form

Eligibility Requirements You must have at least two years of information security related experience. * Application Submission Steps Step 1: Complete the application form Step 2: Ask your Boss / Supervisor / Department head to write a letter in company letterhead confirming your 2 years security related work experience ** Step 3: Attach a copy of your Drivers License Step 4: Fax the above documents to 505.341.0050 or Scan the documents and e-mail them to customerservice@eccouncil.org Step 5: You will receive your CEH exam eligibility code within 2 weeks time Note: We treat personal information securely and confidentially. EC-Council adheres to strict US privacy laws and will not disclose the submitted information to any third party. Applicant Information First Name: Proof of Identity: Residence: Address: City/State/Province: Daytime phone number/Cellular/other: e-mail: (Please write clearly) Country: Zip/Postal Code: Last Name: (Attach Driver's License copy)

(Company e-mail address is required. Your applicatoin will not be proceessed if you use free e-mail accounts such as hotmail, yahoo, gmail, rediffmail etc.) Experience Qualifications Company Name: Company URL: http:// Job Title / Position: Number of Years with This Employer: Type of security related work: Experience qualifications certified by supervisor / agency representative: Supervisor Name: Position: Number of Months of Security related work experience with this employer:

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Exam Eligibility Application Form

Where would you like to take the exam? Statement of Compliance The objective of the certification ‘Certified Ethical Hacker’ is to introduce, educate and demonstrate hacking techniques and tools for legal security testing purposes only. Those who are certified by EC-Council in this discipline acknowledge that such certification is a mark of distinction that must be both earned and respected. In lieu of this, all Certified Ethical...