Brain Injury Florida Annual Conference: Scholarship

Advancing Brain Injury Care in the Sunshine State

PLEASE COMPLETE ONE FORM PER APPLICANT

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• Are You a Person with Lived Experience of Brain Injury?
• Are you a Family Member of a Person with Lived Experience of Brain Injury?

Scholarship Options - check all that are needed

• Conference Registration (includes meals scheduled at Conference) $75
• Transportation expense to get to Conference - up to $50 travel expense will be reimbursed after the Conference - must supply receipts for gas, bus, train, airfare)
• Hotel expense - up to $100 will be reimbursed after the Conference - must supply receipt for hotel stay either the night before the Conference (May 8) or night of the Conference Day (May 9th)

Please explain why you need this Partial Conference Scholarship

How might you benefit from attending the Conference?

Would you be willing to be interviewed about your experience of attending the Conference?

• Yes
• No

Would you be interested in serving on a BIF Committee? Please check which Committee you are interested in serving on:

• Social Media/Website
• Support Groups
• Information and Referral
• Fundraising
• Advocacy
• Conference

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