CBIS/T-AP Application (New Applicant)

Certified Brain Injury Specialist- Advanced Practice/Certified Brain Injury Specialist Trainer- Advanced Practice Application. If you are applying to become a Certified Brain Injury Specialist Trainer – Advanced Practice, please select the appropriate option from the dropdown menu below.

Each application also includes a one year subscription to the Journal of Head Trauma Rehabilitation (JHTR). To receive your copy of the JHTR, enter the applicant's home address below.

Choose an Option

Group ID (Optional)

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Applicant Name*

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Applicant Home Address for JHTR Subscription

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Please enter the applicant's shipping address so that he/she may receive a one-year complimentary subscription to the Journal of Head Trauma Rehabilitation.
e.g., 123 Home Street, City, State 11111

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As noted above, each application also includes a one year subscription to the Journal of Head Trauma Rehabilitation (JHTR). Each applicant must provide BIAA with a home address in order to ensure that the JHTR is delivered to him/her. If a work address is provided, the JHTR will be mailed to that address and may not get to the applicant, depending upon the organization's mail processing procedures.

Application fees are not refundable.

*Please note: The name(s) of the applicant(s) must be entered above before adding the product to your cart.