Helpline 0808 801 0322


Apply to volunteer with Bliss

* Role you are applying for:
Name of unit where Champion is needed:
* Full name:
* Date of birth:
* Address 1
Address 2
* Town
* Postcode
* Best contact number:
* Email
* What weekday and time between 9.00am to 4.00pm is best to contact you?
* Emergency contact name:
* Emergency contact number:
* Emergency contact relationship to you:
Please tell us below why you want to volunteer with Bliss. (Please note that if you have had a premature or sick baby, Bliss requires you to wait at least one year after your baby has been discharged from neonatal care to become a volunteer)
Please explain the skills and experience that you have that will help you in your volunteering role?
Please explain what you hope to gain from your volunteering at Bliss?

Please provide us with the contact details of two people we can contact to act as character referees for you (this cannot be a relative or partner).

Referee one:

* Name:
* Address:
* Post code:
* Best contact number:
* Email
* How do you know this person?

Referee Two:

* Name:
* Address:
* Post code:
* Best contact number:
* Email
* How do you know this person?

Bliss will use the information you have provided to process your application as a volunteer. We will also keep you up to date with volunteering news in the future.

Bliss updates
We’d love to keep you updated with news about our work and ways you can get involved with Bliss to help the most vulnerable babies in the UK. Are you happy to be contacted by:

* Post
* Text message
* Email
* Telephone

We (Bliss and Bliss Scotland) promise we will use th e personal data you have provided to communicate in the way(s) you have agreed to.

We will not pass your details on to any third party organisation for their marketing purposes.

Find out how we look after your personal details visit:

You can opt out of all communications from Bliss at any time by calling the Supporter Engagement Team on 020 7378 5740 or emailing

Criminal records

Due to the nature of the volunteering roles, you are required by the Rehabilitation of Offenders Act 1974 to declare all criminal convictions, including those which are spent. Please note that the disclosure of a conviction or caution may not prevent you from volunteering or working for Bliss, but failure to disclose any conviction or caution will. Please mark the appropriate box.

* Have you ever been convicted of a criminal offence or been subject to a caution or bound over order?
If yes, please state the nature and date(s) of the offence(s):
* Has any social service department or police service ever conducted an enquiry or investigation about any allegations or concerns that you may pose an actual or potential risk to children or young people?
* Have you ever been convicted of any offence relating to children or young people?
* Have you ever been the subject of disciplinary procedures or have been asked to leave employment or voluntary activity due to inappropriate behaviour towards a child?
If you answered yes to any of the above questions, please give further details below.

I confirm that the information I have provided on this form is correct to the best of my knowledge and I consent to my personal data being processed and kept for the purposes described in section 4 in accordance with the Data Protection Act 1998. I understand that some volunteer roles will require a DBS check, the expense of which will be covered by Bliss.

* Name:
* Date: