Brain Injury Association of Virginia Scholarship Request
RequiredRequired Question(s)
Scholarship Request
Deadline for Request: October 21, 2020
 
The Brain Injury Association of Virginia (BIAV), with funding from the Department of Aging and Rehabilitative Services (DARS), is able to assist a limited number of people with the registration cost of our 2020 Making Headway Conference. This assistance is available to caregivers and/or family members of individuals with a brain injury and individuals with a brain injury.

BIAV is offering 10 scholarships, based on need, date of request, and availability of funds.
 
Interested parties are required to submit this Scholarship Request Form prior to registering. If you are applying for a registration fee scholarship for multiple family members,  please complete a separate scholarship request for each individual. 
Questions - conference@biav.net 

 
Required 1.

Name of Applicant

 

50 characters left.
Required 2.

E-mail address

 

50 characters left.
Required 3.

Phone #

 

50 characters left.
Required 4.

Address:

 

50 characters left.
Required 5.

Please explain your financial need for a scholarship for this event:

 

350 characters left.
Required 6.

Please share any other important information in consideration for this scholarship:

 

350 characters left.
Required 7.

 

I understand that any assistance provided by the Brain Injury Association of Virginia will be determined on an individual basis. In the event I am unable to attend the event, I will notify BIAV by October 26th so that my spot may be made available to another individual.
Please enter the responsible party's name below to signify you have read the above statement. Thank you.   


 

50 characters left.