brain injury of northern michigan logo

 


Our mission is to educate and empower our members, providers and the community in the treatment and recovery from brain injuries.

Sleeping Bear

Facebook group

Our Corporate
Members

Corporate Members


Next meeting
July 18th 2019
6:30 - 8:30

Addressing Ballance Complications follow TBI

Meeting Change
Cowell Family Cancer Center

Conference room




 

 

 

 


It takes a community: A collaborative approach to Brain Injury Rehabilitation.


To be a member please fill out the Membership form. Memberships is Due in July. All Members must have a mailing address North of US 10. We have PayPal now so you can pay after you fill out the form. You don't have to belong to PayPal to purchase your membership. Just pay by credit card and at the end of the purchase you will be asked to join PayPal or not join. We also have the ability to pay at the meetings as well. If you dont want to pay online you can scroll to the bottom of this page and print the form and mail or bring to a meeting.

Brain Injury Network of Northern Michigan
Membership Application

Applicant Information
New        Renewal    

Name:

Date

Credentials:

Organization:

Address:

City:

State:

ZIP Code:

Email address:

Website:

Work:

Home:

Cell:

Fax:

Do you want to be listed on the website

Yes

No

What heading do you want to be listed:

 

Membership Options - renewable in July

 

Individual ($25.00)

 

Corporate ($100.0 – up to 5 Members)

 

Additional Corporate Member ($20.00/member)

Total Members

 

Grand Total

 

 

 

You can also print the form and mail or bring to a meeting.

Membership Form
Mail to
BINNM
PO Box 504 (New PO Box)
Traverse City, MI 49685-504