BIALA Annual Conference
Exhibitor Form

The BIALA Annual Conference presents an incomparable opportunity to promote your organization to highly specialized professionals and strengthen your brand identity. Exhibitors will enjoy direct access to the leaders in our state and region who are helping to shape the future of brain and spinal cord injury treatment and rehabilitation.

BIALA Annual Conference Exhibitor Online Application

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.

Corporation ............................................. $350.00

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.

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

EXHIBITOR BOOTH INSTRUCTIONS FOR SET UP/BREAK DOWN:
Set-up and Breakdown instructions: Exhibitors are located in the Bayou Room across the hall from the general session hall. Depending upon your needs, you may enter through the front lobby of the hotel (surrounded by parking), or unload at the back entrance of the hotel, or at the loading dock on the side of the hotel. For further assistance, please call the hotel representative, Flora Thompson, 504-303-3045, or Kimberly Fleming, 504-303-3002. SETUP: As early as Thursday, March 25, 5 p.m.; otherwise early Friday morning (Registration is 8 a.m.- 9 a.m. and conference starts at 9 a.m.) BREAKDOWN immediately follows the close of the conference on Saturday, March 27.

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 online membership form above, or click the button to download a paper copy.

DOWNLOAD OUR EXHIBITOR APPLICATION

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Having a spinal cord injury is very challenging but with the support I have received from BIALA, life is a little easier. The kindness and compassion I receive when I call the hotline is wonderful plus the resources I learn about are invaluable. My spirits are always lifted after I reach out to BIALA.

Caroline Nick

Individual with SCI

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When I called the helpline, I was so happy to learn about the trust fund I could apply for. I had no clue about it but am glad I know now because living with a brain injury is expensive and hard. The lady I spoke with was so nice, took the time to answer all my questions, and made me laugh. She gave me some hope and that is pretty cool.

Harry Thomas

Individual with TBI

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The stress of everything is overwhelming. Every place and person I have called has shut the door in my face, and I felt like I was drowning. No one wanted to help until I called you. You have been an angel sent to me who has been incredibly kind, willing to listen and also help find what we need. By sharing your own personal stories, you have shown me that there is hope. Having you to talk to has been such a comfort and I just can’t say thank you enough. This has been an incredibly hard road but now that I have found you, it has become easier because I know there is someone who cares. Thank you from the bottom of my heart, my sweet angel, and thank you for shining some hope back in my life.

Mary Katherine Greer

Caregiver

Resource CEnter

BIALA Annual ConferenceExhibitor Form