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GOVERNMENT BACKED SCHEME
Your Grant Application
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Are you or anyone in your household in receipt of benefits, child care benefits or working tax credits such as these:
Benefits
Pension Credit
Income based Jobseeker's Allowance
Income Support
Tax Credits (Child or Working Tax Credit)
Universal Credit
Income Related Employment & Support Allowance
Housing Benefit
None
Is your Household income Under £31k?
Household Income
Please Select
Yes
No
Do you have any Health Condition?
Health Condition Options
Limited Mobility
Immunosuppressed
Cardiovascular
Respiratory
None
Please select your heating type
HeatingType
--
Main Gas Boiler
Electric Storage Heaters
Electric Heating
Solid Fuel
Electric Panel Heaters
Electric Wet Radiators
Warm / Blow Air Heating
I don't have any heating
Are you a homeowner?
homeowner
--
Yes
No
Is your boiler more than 15 years old?
boilerAge
--
Yes
No
Unsure
Contact Details
Full Name
Email Address
Phone Number
House Number
Postcode
Check If You Qualify
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