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Apply For Membership 

As an association, our beneficiaries are our Members. The circumstances in which you sustained your injury will depend on which membership category you fall into, but this does not affect the support you receive.

Fill out this form to enquire about becoming Member of Blesma. The form will go to our membership team who will oversee your application from there.

To complete this form you will need the following....

    • A copy of one of the following documents: Veterans ID card, Certificate of Service/War Pension or AFCS entitlement letter.
    • If you do not have this information please also fill out the Data Disclosure Authority form so Blesma can verify your service. 
    • Your NI number
    • Details of your service 
    • Your NHS number

If you need any assistance whilst filling out this form please contact Membership Admin on 020 8548 7093

* indicates mandatory fields

1 YOUR DETAILS

DD/MM/YY

We use this number when communicating with NHS services, such as Hospital transport or GPs and it allows us to identify you to such services securely in written communications without using patient identifying information. You should be able to find your NHS Number on any letter or document you have received from the NHS, including prescriptions, test results, and hospital referral or appointment letters. If you cannot find your NHS Number at home, you can ask your GP practice to help you.

DD/MM/YY

2. SERVICE DETAILS

If you do not have this please fill out the Data Disclosure Form listed at the top of this page. If we need to contact the Service records department your application may be delayed by up to 6 weeks.

DD/MM/YY

DD/MM/YY

3. DETAILS OF YOUR DISABLEMENT

a. Amputation – please tell us which limb or limbs you have had amputated and when.

DD/MM/YY

b. Loss of Eye(s)

c. Loss of Use of Limb(s)/Sight/Hearing – Not amputation

DD/MM/YY

4. DETAILS OF ANY BENEFITS OR SUPPLEMENTARY ALLOWANCES

Do you receive any of the following?

Declaration

I authorise Blesma The Limbless Veterans and its agents to act on my behalf and grant them full authority to discuss, disclose and receive personal and confidential information from Veterans UK, Department for Work and Pensions and NHS. I note that Blesma reserves the right to carry out checks in relation to my service. I authorise Blesma The Limbless Veterans to use my details to make contact, pass information, advice and Association material and provide support, prevent fraud, and comply with legal obligations.

I also do hereby undertake to pay the sum of £1.00 if Blesma The Limbless Veterans was ever to be wound up. Please consider this application for membership and I agree to abide by the Constitution and Rules and Code of Conduct.

As Blesma is a Membership Association successful applicants will be required to pay a Membership Subscription Fee which is £1 (one) on joining and £1 (one) per year thereafter OR a one off life payment of £2 (two) pound's on joining. This will be collected once membership is confirmed in writing and details of how to pay this will be contained within the Welcome Letter sent to new members.

Prefer a paper form? If you prefer a printed version of this form click here and return with copies of any supporting documents to Freepost BLESMA

 Looking for our Constitution? To read Blesma's Articles of Association and Rules in full click here

To read our Code Of Conduct in full click here