Corporate Membership Form

  • Must include http://www. for form to be accepted.
  • To receive discounts for events, you will need to a login when registering. Please enter a preferred username. If left blank, a username will be created for you.
  • Please enter a preferred password. If left blank, a password will be created for you. Passwords must be at least 8 characters long and contain a mix of upper and lower case letters and numbers.
  • Member 1

    Each corporate membership includes 2 named members, the president & a corporate contact
  • Member 2

    Each corporate membership includes 2 named members, the president & a corporate contact
  • Directory Information

    This is the information we need to complete your directory listing. Please be enter the requisite information so potential clients will be able to find you.
  • This will be the address listed in the directory. It is used in the search function to help users find the services closest to them.
  • This will be used for billing and mailing physical copies of publications. This will NOT be listed in the directory.
  • Provided a narrative description of your program/services limiting your description to 250 words.
  • Payment

  • American Express
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
  • $0.00
  • This field is for validation purposes and should be left unchanged.

Membership Details

  • Discounts for Legacy Society Tribute Award black tie gala, Annual Fall Conference, and other major BIAMI events and programs
  • Networking, sponsorship, and exhibitor opportunities
  • BIAMI website directory listing
  • Emerging Leaders and Young Professionals networking, social, and educational opportunities
  • Strength in numbers advocacy in Lansing for relevant brain injury policies and programs
  • No-cost BIAMI and Brain Injury Association of America publications
  • Membership fee includes two personnel
  • Additional memberships available at $40 per person
  • The knowledge that your corporate membership supports Michigan's 200,000 brain injury survivors and strengthens the nations largest network of brain injury providers
Eisenhower Center
Special Tree
Community Connections
Lightouse Neurological Rehabilitation Center