Join CBN

Welcome

Thank you for your interest in joining CBN or renewing your membership.

If you have any problems in completing this form, please contact us at cbn@ncb.org.uk or 020 7843 6309 to update your details. Thank you.

Membership type

Organisational memberships include a license to use the Child Bereavement Service Questionnaires (CBSQs) to evaluate your service.

Please select your annual membership:

Large Organisation (annual income £50,000+): £90Small Organisation (annual income under £50,000): £50Additional Organisation Address (for local branch of national member, e.g. Cruse area, Marie Curie hospice): £10

Please Note:

You chose Large organisation, for those with an annual income of £50,000 or more.

If this isn’t correct, please return to the shop by clicking here.

Please Note:

You chose Small organisation for those with an annual income under £50,000

If this isn’t correct, please return to the shop by clicking here.

Please Note:

You chose Additional address (for a local branch of a national CBN member, e.g. Cruse area, Marie Curie hospice)

If this isn’t correct, please return to the shop by clicking here.

Service type

Application Status

Membership Type

Bereavement Service

Your details

Organisation name

First name

Last name

Email

Phone (tip - please don't leave any spaces)

Address

Street address

Town/City

County

Postcode

Region

Country

Organisation phone

Organisation email

Website

About your services

Please describe your organisation, including any support you provide to children, young people and those caring for them before and after a death (e.g. 1:1 support, closed group activities, family days, training for schools).

If your organisation provides free, direct support to children, young people and those caring for them, before and/or after a death, and families can refer themselves directly, would you like these details to published in our online map of of support services at www.childhoodbereavementnetwork.org.uk ? Please note that inclusion is at the discretion of CBN staff.

YesNo

Please provide some more details about the support your organisation offers

If we include your service details on our map, we may include the information you give in this section.

What is the name of your service?

Our service is known by a different name

Alternative Service Name

What geographical area does your service cover? Please tell us about any aspects provided nationally

Telephone number for public enquiries

When do you support families?

Before a deathAfter a deathBoth

What age children and young people do you support?

Can any family refer themselves directly to you for support around a death?

Please give details

In what situations does your service support children and their families?

Please give details

What types of death does your service work with?

Please give details

Is there a charge for your service?

Please give details

Last year, roughly how many bereaved children and young people (or those facing expected bereavement) did you support face-to-face?

Thank you for giving us this information about your organisation. It will help us improve signposting and information about the support available.

Colleagues

You will be the main contact for your organisation, but if you have other colleagues who would like to receive our email bulletin, please give us their details here.

First Name

Last Name

Job title

Email

Declaration

Endorsment

Endorsing CBN's Vision, Aims, Belief Statement and Guidelines as a framework for good practice is a condition of membership.

Please confirm

Yes, I endorse them

Would you like to be added to our members' discussion forum so that you can participate direct from your inbox? Other members will see your name, but not your personal email or other details.

YesNo

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