testing test

Name

Postcode*

Door number*

Email Address

Phone Number*

Primary measure of interest*
Please selectGas Boilers UpgradeSolid Wall InsulationElectric Storage HeatersCentral HeatingAir Source Heat PumpSolar PanelsLoft InsulationCavity Wall InsulationUnder Floor Insulation
Current Heating System*
Please selectGas Boiler Installed 1920 - 2005Gas Boiler Installed Installed 2006 - 2011Gas Boiler Installed Installed 2011 - 2023The gas boiler looks MORE than 15 years oldThe gas boiler looks LESS than 15 years oldGas Fire/Warm Air System or any Other gas SystemElectric SystemUnlisted Option
Qualifying Criteria*
Please selectIncome 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 BenefitPension Credit Savings Credit (PCSC)No benefits but low income household below £31,000 a yearNHS referral letter Cardiovascular, Respiratory, Limited Mobility or ImmunosuppressedNo benefits, no Health Issues and my income is ABOVE £31,000
Property Occupancy
Please selectOwner occupiedRentalSocial Housing
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