Brain Injury Association of Sault Ste. Marie and District
  • Home
  • Association
    • About
    • Services
    • Gallery
    • Contacts
    • Resource Links
    • Board of Directors
    • Financial Statements
    • Membership >
      • Membership Form
  • Survivor's
    • Peer Support Program
    • Survivor's Support Group
  • Caregiver's
  • Donations
    • Donate
    • Donor and Sponsor Page >
      • In Memoriam
      • Notes and Letters
  • About Brain Injuries
    • Concussion
    • Community Resource Info
  • Events
  • Borrow a Tent

Brain Injury Association of Sault Ste. Marie and District
Membership Form


  • Brain Injury Association of Sault Ste. Marie and District

  • Membership Form

    This form is for joining only the BIASSMD. If you wish to join both the BIASSMD and OBIA please click the button below to go back to the membership page.

  • Personal Information

    All information you provide will not be shared with any other agency or business without your written agreement.

  •  -
  •  -
  • I agree to the fee noted above and realize that this fee is not a charitable donation and is not claimable inaccordance with the Income Tax Act of Canada.

    I hereby request membership in the BIASSMD.

  • Participation in Association Activities:

    Please provide an answer to each of the following quesitions. Would you consider:

  •   Very Interested interested Somewhat Interested Not Interested
    Fund Raising
    Writing/Editing Newsletter
    Manning the office
    Advertising and Promotion
  • PLEASE DO NOT SUBMIT - PRINT AND MAIL. Thank you and welcome to the Brain Injury Association of Sault Ste. Marie and District. Someone will be in touch shortly.

  • Please mail this application and a cheque for the specified amount to:

    Attention: Chantal Scopacasa

    P.O. Box 22045, 

    Sault Ste. Marie ON, 

    P6B 6H4  

  •  
  • Should be Empty:
Powered by Create your own unique website with customizable templates.