Thank you for supporting the Brain Injury Alliance of Connecticut (BIAC).
Please use the form below to purchase your BIAC Annual Membership. To make a general donation, please click
here
.
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Required Fields
Membership Option
Amount
$45 – Individual Membership
$70 - Family Membership
$125 - Professional Membership
$175 - Providers Council Membership (Annual Budgets up to $200k)
$350 - Providers Council Membership (Annual Budgets over $200k)
$500 - Providers Council Membership (Annual Budgets over $400k)
$575 - Providers Council + Prem. (Budgets up to $200k)
$750 - Providers Council + Prem. (Budgets over $200k)
$900 - Providers Council + Prem. (Budgets over $400k)
$500 - Premium Package Only
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Brain Injury Alliance of Connecticut
200 Day Hill Road, Suite 250, Windsor, CT 06095
860-219-0291 | www.biact.org
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