YOUR GRANT APPLICATION Are you a benefit recipient? *YesNoIdentify your benefit:Income based Jobseekers Allowance (JSA)Income Based Employment & Support Allowance (ESA)Income SupportPension Credit Guaranteed CreditWorking Tax CreditChild Tax CreditUniversal CreditPension Credit Savings CreditChild BenefitHousing BenefitYou must receive benefits from the government to be eligible for this Free Boiler Replacement GrantWhat is your home ownership status? *HomeownerPrivate TeneantHow do you keep your home warm? *ElectricGasOthersDo you have gas metre installed? *YesNoIs your boiler installed before 2005? *YesNoDo you have radiators installed? *YesNoWhat is your Existing boiler type? *SelectCombi Boiler - (No Tank Attached)Boiler With A Cylinder AttachedNo Heating System FittedBack Boiler Behind The FireUnsureYour Property Style?FlatBungalowTerracedEnd TerraceSemi-DetachedDetachedWould you also like insulation? It’s totally free.Loft InsulationRoom in Roof insulationInternal Wall insulationCavity Wall insulationUnderfloor insulationExternal Wall insulationNumber of Bedrooms?1 Bed Room2 Bed Rooms3 Bed Rooms4+ Bed RoomsName *Email Address *Phone *Street Address *PostcodeBest Way to Contact you?SelectCallTextEmailBest time to contact you?SelectMorningAfternoonEveningOthersDo you know the make and model of your old boiler?Attaching pictures here will help us to fast track your applicationDrag and Drop (or) Choose FilesSubmit
