Corporate Friends Sponsorship

CLICK HERE TO COMPLETE THE ONLINE FORM

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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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In between my therapies, I wanted to keep moving forward so I reached out to find some ideas of ways to keep my brain working. They were so helpful and friendly and gave me many great ideas to try. We were even laughing together, and it made it feel like I was talking to a friend.

Bobby Bodin

Individual with TBI

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The BIALA hotline has been a huge source of hope for me. As the mother of a daughter who has a brain injury, it has been extremely comforting to be able to talk to someone who is empathetic, kind and comforting. Somedays I just need someone to talk to so it is great knowing there is someone there willing to listen to me.

Avery Shelton

Caregiver

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Thank you for your kind words and speedy reply. You have been lovely trying to help me help my brother. You have been brilliant taking time to research my requests for me which has allowed me to spend more time assisting my brother. Thank you for being such a blessing.

Constance Urban