What best describes your housing ownership status?

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Homeowner

Private Tenant

Private Landlord

Social Tenant

What's your main source of heating?

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Mains Gas

Electric

Oil

LPG

Solid Fossil Fuel

No Mains Heating

Which type of property do you live in?

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Detached House

Semi-detached House

Mid-terrace House

End-terrace House

Bungalow-detached

Bungalow-semi detached

Bungalow-mid terrace

Flat or Maisonette

Park Home

Which of these income related benefits are you or a member of your household on?

Please select all that apply *

Income Support

Housing Benefit

Universal Credit

Income Based Jobseekers Allowance

Pension Credit Guarantee Credit

Working Tax Credit

Child Tax Credit

Income related Employment & Support Allowance

Pension Credit Savings Credit

Child Benefit

None of the Above

Is your household income less than £31,000 a year?

(Field Required) *

Yes

No

Your address and postcode

1st Line of Address *

2nd Line of Address (Optional)

Town/City *

Postal Code *

Your details

First Name *

Last Name *

Your contact details

Mobile Phone number *

Email address *

I agree to your Privacy Policy . And by providing my contact information, I agree to be contacted by you (and your installation company partners) so that my eligibility can be confirmed, a survey booked an installation date set.

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