Thank you for your interest in the Check Point Authorized Training Center Program.

Please complete this form and forward electronically to

Date:
Company Name:
Requestor Name:
Address:
City: / State: / Postal Code:
Email: / Country:
Fax No.: / Phone:
What year was your company founded? / What is your total number of employees?
CEO: / Training Manager:
Email: / Email:
What was your approximate annual revenue for 2004?
Less than $100,000 / $5 million - $10 million
$100,000 to $500,000 / $10 million - $20 million
$500,000 to $1 million / $20 million +
$1 million to $5 million
What is the percentage of revenue in each of the following areas? (Total must be 100%)
Hardware Revenue / Software Revenue / Services Revenue
Current Security Market Activity (please check all that apply):
Not Active / Reseller- Other Security Vendor Products / Services Revenue
Reseller-Check Point / Reseller-Other Products/Services / Training Delivery
Other
Please list the other Security vendor products your company sells/supports

Below list the areas (cities) in which you are interested in providing training. Check Point will evaluate your desired locations and may or may not approve any or all of those locations.

(Check Point requires permanent training facilities in which to teach its courses)

***Please send digital pictures of your training facility (external building, training room, reception area)

List Professional Trainers employed by your company and the certifications they hold
What Check Point courses does your company plan to teach?
What other training courses does your company currently offer?
When would you plan to hold your first Check Point training?
What was the total number of students trained at your facility last year, if applicable?
What is your projected number of students to be trained on all course offerings in the
next 12 months?
Do you plan on offering night and/or weekend courses?
Do you plan on offering financing options for applicable students?

Once you’ve completed this form, please forward electronically to and allow 2 to 4 weeks for your application to be processed.

Please note: this application does not constitute approval for the requested ATC site.

Check Point Software Technologies LTD., Page 2 of 2