Membership

Become a part of the Brain Injury Association of Kansas and Greater Kansas City team! Membership is available to anyone that wants to be a part of our growing organization. Funds from membership assist us in achieving our mission of improving the lives of survivors of brain injury and their families.

Benefits of Membership:
Discounts on BIAKS sponsored activities; subscription to THE Challenge, published by Brain Injury Association of America; quarterly BIAKS newsletter; email of legislative alerts; email notifications of conferences and activities. Membership is for one calendar year.

Corporate Members

• Burnett & Driskill – Attorneys at Law
• communityworks, inc
• Brennan Gott Law, LLC
• Meadowbrook Rehabilitation Hospital
• NeuroRestorative
• Mid-America Rehabilitation Hospital
• Pottroff Law Office, P.A.
• Rehabilitation Institute of Kansas City
• The Dream Works
• Quality Living, Inc.
• Wesley Rehabilitation Hospital

To become a member, simply complete the form below:

* Required

Title DR MISS MR MRS MS

First Name *

Last Name *

Email Address *

Company Name (if applicable)

Address *

City *

State *

Zip Code / Postcode *

Country * -- Select Country -- CANADA UNITED STATES

Home Phone Number

Work Phone Number

Cell Phone Number

Select a membership level* Individual Memberships: Basic Membership: $35 Supporting Membership: $5 Professional Membership: $50 Business Memberships: Organization Membership: $200 Corporate Membership: $500

Name on Card *

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Card Expiration Date* 01 02 03 04 05 06 07 08 09 10 11 12 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Card Type * Visa Master Card American Express

CCV Number *

Check this box if you'd like to subscribe to the BIAKS Email Newsletter

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