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COMPLETE THE BELOW SECTIONS TO SEE IF YOU QUALIFY FOR A GRANT
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Name
*
Email
Phone
*
Address
Product Interested in
Loft Insulation
Air Source Heat Pumps
Ventilation
External Wall Insulation
Gas, Oil or LPG Boiler
Internal Wall Insulation
Floor insulation
If you or someone in your household DOES NOT claim benefits, you may still qualify. Please select which county you are in
Conwy
Denbigh
Flintshire
Other
Someone claims benefits
Tick the relevant boxes where applicable
Child Tax Credit
Child Benefit
Pension Credit Guarantee
ESA - Income related
Income Support
Working Tax Credit
Armed Forces Independent Payment
Attendance Allowance
Carers Allowance
DLA - Disability Living Allowance
Severe Disablement Allowance
War Pensions Mobility Supplement change
Industrial Injuries Disablement Benefit
PIP - Personal Independence Payment
Constant Attendance Allowance
JSA - Job seekers Allowance - Income related
Universal Credit
EPC RATING , F or G - Check on the EPC register
House type
Semi Detached House
Detached House
Terrace House
Semi Detached Bungalow
Detached Bungalow
Age of boiler
Is your house
Solid walls
Cavity walls
Not sure
Number of bedrooms
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Is your boiler
Mains gas
Oil
LPG
No boiler present / electric heating
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