Occupancy Status
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Home Owner
Private Rented
Social Tenant
Other
Does anyone in your household receive a state benefit?
If yes, please tell us what type of benefit it is. (Click all that apply)
Income Based Jobseekers Allowance (JSA)
Income Related Employment and Support Allowance (ESA)
Income Support (IS)
Pension Credit Guarantee Credit (PCGC)
Working Tax Credit (WTC)
Child Tax Credit (CTC)
Universal Credit (UC)
Housing Benefit
Pension Credit Saveings Credit (PCSC)
Others
Heating Type
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Gas
Lpg
Electric
Oil
Other / I'm Not Sure
What Measures are you interested in? (Click all that apply)
Air Source Heat Pump
Home Heating Upgrade
Insulation
Other
First Name
Last Name
Phone No
Email
Preferred Contact Type
Phone
Email
House No
Post Code