Annual Convention, February 28 to March 3, 2009 — (Westin Diplomat Resort and Spa, Hollywood, FL)

Please complete the form below to guarantee a spot at the conference (red indicates required field). Space is limited and reservations can only be accepted on a first-come, first-served basis.

Name:

First Name for Badge:

Title:

Company:

Address:

City/State/Zip:

Phone:

Fax:

E-mail:

Parent Company:

Additional Team Registrants:

Name: (1)

Title:

First Name for Badge:

E-mail:

Name: (2)

Title:

First Name for Badge:

E-mail:

Name: (3)

Title:

First Name for Badge:

E-mail:

A limited number of rooms are being held for the BISA at a preferred rate of $329.00 (single or double) per night. Please call the hotel reservations office directly at (888) 627-9057 and be sure to ask for the special BISA Convention rate. The group rate is guaranteed through January 30, 2009 or until the room block is sold out.

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