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| Required fields in RED. |
| Event |
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| Company |
Please type N/A if you are not employed.
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| First Name |
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| Last Name |
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| Add additional guests in the box. If you don’t know the names of your attendees, please enter the number of additional guests in the field below and you will need to submit the names of your attendees by 5:00pm, the day before an event. |
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| BIAMember Company? |
Yes
No |
| Address |
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| Suite/Unit |
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| City |
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| State |
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| Zip |
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| Email |
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| Phone |
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| Mobile |
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| Fax |
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| ALL reservations for events must be PRE-PAID by credit card below or company check received no later than check-in time at the event. All walk-up attendees must also pay by cash, check or credit card at the door. Invoice option is only available to sponsor members in good standing and will include an additional $10 per person fee to be invoiced. Please contact BIA at 949.224.0321 with any questions. Thank you. |
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| If you are a BIA Member Company, you have the following payment options: |
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Sponsor (BIA staff will check your company's sponsorship before confirming your reservation) |
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Mailing a check (check should be made payable to BIA/OC, and mailed to 17744 Sky Park Circle, Suite 170, Irvine, CA 92614 within 3 business days before the event) |
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Credit Card (Complete Information Below) |
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| If you are not a BIA Member Company, a credit card is required for all reservations. Please select credit card option above and complete below. |
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| Credit Card Information |
| Name on Card (as it appears on card) |
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| Card Type |
Visa
MasterCard
AmEx |
| Credit Card Number |
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| Expiration Date (MM/YYYY) |
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Security Code (last 3 digits on back of Visa/MC or 4 digits on front of AmEx)
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Billing Address of credit card, including zip code
Same as above |
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| Notes/Special Requests |
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| ALL reservations not cancelled by the cancellation deadline are non-refundable and will be billed per association policy. Cancellations must be requested in writing by email and confirmed by BIA staff before the cancellation deadline (typically 3 business days before the event.) Reservations for the program are required to participate in networking prior to entry into event. Non-members are limited to two events per year.
By submitting this reservation, I acknowledge the reservation and cancellation policy.
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