We are accepting nominations for 2 survivors (with one caregiver each) to go to the BIAMI Fall Conference September 22, 2023 at the Lansing Center. Each Survivor will receive a 1-night stay (Thursday night), a ticket to the survivors dinner on Thursday evening, entrance fees to the conference on Friday, and a $100.00 gift card to assist with transportation and other incidentals. Survivor must reside in Northern Michigan (north of US 10). The Survivor must not have other financial means (e.g., insurance funds, sponsors, etc.) to attend the conference. Entry deadline is August 30th, Drawing will be held August 31st and the Nominator and Survivor will be notified on September 1st

Brain Injury Association of Michigan Annual Conference Sponsorship form

Survivors Name Date
Survivors Address
Survivors Phone # Survivors Email

Reason for Nomination
Nominator Name
Company
Nominator Phone # Nominator Email

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

Sponsorship Form
Mail to
BINNM
2175 Cove Dr
Traverse City, MI 49685