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
Special Tree
Community Connections
Lightouse Neurological Rehabilitation Center