B:CAN Application Form

Organisation Details

Name of Organisation(Required)

Address(Required)

Street Address Address Line 2 City Post Code Country

4. What year were you formally incorporated?(Required)

Website

Contact Details

Name of Contact (CEO or equivalent)(Required)

First Last

Contact Telephone Number(Required)

Email Address

Membership Type

Please refer to the B:CAN Membership criteria by clicking here

Membership Type(Required)

Member

Affiliate

Partner

Financial Information

Annual Turnover (£) for the last 3 financial years (if available)

2024/2025(Required)

2023/2024(Required)

2022/2023(Required)

2021/2022(Required)

Reserves for Last Financial Year(Required)

Service Delivery

Which Birmingham Wards do you provide the majority of your services in?(Required)

Organisation Assets

How many buildings or facilities do you have?(Required)

Are these buildings:

Leased

Owned

Other

If ‘Other’, please specify

Governance

How do local residents influence your decision making, work and priorities? (e.g. Board, Committee level etc)(Required)

Staffing and Volunteers

Number of Staff – Full-Time(Required)

Number of Staff – Part-Time(Required)

Number of Volunteers(Required)

Main Activities / Services Provided

Tick all boxes that best describe your organisation’s main activities/services provided(Required)

If ‘Other’, please specify

Accreditations Held

Please tick all current Accreditations held by your Organisation

Matrix Standard – quality framework for information, advice, and guidance services

Investing in Volunteers – UK quality standard for volunteer management

Fundraising Regulator Registration – ethical and transparent fundraising practices

Investors in People (IIP) – enhancing employee engagement, development, and wellbeing

Disability Confident Employer Mark – commitment to inclusive hiring and supporting disabled employees

ISO 9001 Quality Management – ensuring quality, transparency, and efficiency

ISO 14001 Environmental Management – commitment to environmental best practices

CQC Registration – meeting essential standards of Health and Social Care quality and safety

Other

22. If ‘Other’, please specify

Declaration

By submitting this form, I confirm that the information provided is accurate to the best of my knowledge. I understand this information will be used by BCAN for Membership Administration and Strategic Development in accordance with Data Protection Regulations.

Name(Required)

First Last

Date(Required)