Corporate Friends Sponsorship

CLICK HERE TO COMPLETE THE ONLINE FORM

CLICK ON THE IMAGE BELOW TO DOWNLOAD THE FORM

EXHIBITOR TYPE

Non-Profit ........................................ $200.00

Table in Vendor Exhibition area, with up to 2 people per table.
Access to the conference for 2 individuals with complimentary meals.
Listed as a vendor on BIALA website.

*There is a flat fee for those seeking CEUs: $50 per person.

Non-Profit ............................................. $350.00

6 ft. table in Exhibit Hall with 2 chairs
Access to the conference for same 2 individuals with complimentary meals and CEUs
Listed as an exhibitor in conference program and on BIALA website
Included in BIALA's online resource guide

Corporation ............................................. $500.00

6 ft. table in Exhibit Hall with 2 chairs
Access to the conference for same 2 individuals with complimentary meals and CEUs
Listed as an exhibitor in conference program and on BIALA website
Included in BIALA's online resource guide

*There is a flat fee for those seeking CEUs: $50 per person.

General Contact Information

Company/Organization Name *

Name of FIRST Representative*

Email Address *

Phone Number *

Seeking CEUs? *

Yes

No

If Yes, list discipline:

Joining Us For Lunch? *

Yes

No

If Yes, list dietary restrictions:

Name of SECOND Representative*

Email Address *

Phone Number *

Seeking CEUs? *

Yes

No

If Yes, list discipline:

Joining Us For Lunch? *

Yes

No

If Yes, list dietary restrictions:

Business Mailing Address

City *

State *

Zipcode/Postcode *

Will You Require Electrical Setup? *

Yes

No

If Yes, please submit $20 electrical set up fee.

Is your organization willing to donate a small door prize (i.e. $25 gift certificate, goodies basket, etc.) *

Yes

No

Authorization for Photo,Video, or Audio Recording of Presentation:
I grant permission to BIALA, itsrepresentatives, employees and volunteers the right to take photographs, videoand/or audio recordings in connection with any educational presentation, andauthorize BIALA, its assigns and transferees the right to use or publish samein print or electronically.My name and date entered below is myapproval for BIALA to use photographs/video/audio recordings of me (with orwithout my name) for any lawful purpose, including education, publicity,illustration, advertising, and web content.

Please fill out our exhibitor form above, or click the button to download a paper copy.

DOWNLOAD OUR EXHIBITOR APPLICATION

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First of all, thank you! Thank you for the magnificent website you have developed! I found some great information to help me with my fight against my own TBI. Resources just around the corner from where I lived that none of my doctors have referred me to are now at my fingertips. I continue to struggle and now am inspired to fight for others. I can't thank you enough for the work you have done.

Nicole Broussard

Individual with TBI

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Living with a spinal cord injury has been a challenge but the peer mentor program has definitely assisted me in adjusting to my new normal. Thank you for giving me hope.

Emerson Moss

Individual with SCI

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Attending a Connections Circle event and meeting new people and learning that I can still enjoy life even with my spinal cord injury was a blessing. I haven't picked up a bowling ball in 30 years, and today, when I did, my first bowl was a strike. This smile on my face won't go away.

Chris Alford