28th NORTHEAST REHAB SYMPOSIUM

Exhibitor Registration Form Fill out form below or print and mail Exhibitor Registration Form PDF

Exhibitor Registration $425 due 10/8/2025

I hereby request a reservation for an exhibit booth for the 28nd Annual Northeastern Rehabilitation Symposium to be held at Hotel Bethlehem in Bethlehem, PA on Sunday, October 14, 2025. I understand that booth locations will be reserved on a first come-first serve basis and that no booth will be reserved without remitting a non-refundable fee. If you have any questions, please contact Bill Dempsey at wdempsey@nerehab.com or (570) 344-3788 ext 320. *Refunds will be issued up to 2 weeks before the symposium (less a $10.00 cancellation fee per individual). Deadline for vendor registration and payment: October 8 2025 This reservation form is executed by the undersigned as an authorized representative of the above named company.

Company Name

Attendee Name(Required)

First Last

Title

Phone

Fax

Address

Street Address Address Line 2 City State ZIP Code

Booth Type(Required)

Representative 1

Name

First Last

Title

Phone

Representative 2

Name

First Last

Title

Phone

28th NORTHEAST REHAB SYMPOSIUM