2025 Exhibitor Louisiana Obesity Conference

2025 Louisiana Obesity Conference

Exhibitor Information
Company Name*
Main Contact*

First NameLast Name
Email*
example@example.com
Contact Phone Number*
Please enter a valid phone number.
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Meeting Support
Marketing Support*

Basic Exhibitor Package - $2,000Bronze Package - $3,000Silver Package - $5,000Gold Package - $7,500Platinum Package - $10,000
Special Requests*

Electricity ($50.00)Additional Representative(s) ($150 each)Shipping & Receiving (company expense; will send info once we receive your form)AV equipment (company expense; will send info once we receive your form)No special requests
Exhibitor Badges
Representative #1

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Representative #2

First NameLast Name
Email - Rep #2
example@example.com
Phone Number - Rep #2
Please enter a valid phone number.
Representative #3

First NameLast Name
Email - Rep #3
example@example.com
Phone Number - Rep #3
Please enter a valid phone number.
Representative #4

First NameLast Name
Email - Rep #4
example@example.com
Phone Number - Rep #4
Please enter a valid phone number.
Representative #5

First NameLast Name
Email - Rep #5
example@example.com
Phone Number - Rep #5
Please enter a valid phone number.
Representative #6

First NameLast Name
Email - Rep #6
example@example.com
Phone Number - Rep #6
Please enter a valid phone number.
Exhibitor Information
List Companies you would prefer not to be located nearby
Please indicate the products or services you will display*
Upload Logo (Silver, Gold, and Platinum Exhibitor Packages)*

Cancelof
Payment Center
Payment Method*
By Check

Please make check payable to the LA-ASMBS and send to:

LA-ASMBS
Attn: Janna Pecquet
2213 Danny Park
Metairie, LA 70001

For more information, please contact Janna Pecquet
Email: janna@laasmbs.org

Should be Empty:

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

2025 Louisiana Obesity Conference

Meeting Support

Exhibitor Badges

Exhibitor Information

Payment Center