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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

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.

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

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

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