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Scholarship Application
16th Annual Conference on Defining Moments in Brain Injury

September 15, 2025 * DoubleTree by Hilton, Portland, Maine

We offer a limited number of scholarships for Maine brain injury survivors and family members. The scholarship will pay a portion of your registration fee, bringing your registration fee to $20.

Please fill out the form below to apply. If your application is accepted, you will receive an email with instructions on how to register. The deadline to apply is August 15, 2025.

1.Name(Required.)
2.Address(Required.)
3.Phone Number(Required.)
4.E-mail Address(Required.)
5.I am a:(Required.)
6.Have you previously received a scholarship from BIAA-ME to the BIAA-ME conference?(Required.)
7.If you answered yes to Question 6, in which year did you receive the scholarship?(Required.)
8.Please tell us about your interest in attending.(Required.)
For more information, contact Laura Ksycewski at lksycewski@biausa.org, 703-761-0750 ext. 625.