Please note:

The scheme for which you are applying is available in
England and Wales only. Click GO to start your application

Other schemes run in Northern Ireland and Scotland
and which can NOT be applied for here.

Part I

This 1st section applies only to those over 60 in receipt of one or more of the following benefits. Tick all that apply then click GO, or please click GO now if none of this applies to you.
Council Tax Benefit (not single occupancy discount)
Housing Benefit
Income Support
Job Seekers Allowance (INCOME BASED)
Pension Credit (not standard state pension)
Income-related Employment and Support Allowance

Part II

This section is only for householders with a child under 16, or pregnant women with maternity Certificate MAT-B1. Tick all that apply then click GO, or please click GO now if none of this applies to you.
Claiming as you are pregnant with Maternity Certificate MAT-B1?
Claiming as you have a child under 16 living with you?
Council Tax Benefit (not single occupancy discount)
Housing Benefit
Income Support
Job Seekers Allowance (INCOME BASED)
Pension Credit
Income-related Employment and Support Allowance

Part III

All other householders not eligible under the previous 2 sets of criteria. To be eligible, you must be on at least one of the following benefits. Please choose any applicable. Tick all that apply then click GO, or please click GO now if none of this applies to you.
Working Tax Credit (with an income of less than £15,460, which must include a disability element)
Disability Living Allowance (not child DLA)
Child Tax Credit (with an income of less than £15,460)
Housing Benefit (which must include a disability premium)
Income Support (which must include a disability premium)
Council Tax Benefit (not single occupancy discount) (which must include a disability premium)
War Disablement Pension (which must include a mobility supplement or Constant Attendance Allowance)
Inustrial Injuries Disablement Benefit (which must include a mobility supplement or Constant Attendance Allowance)
Attendance Allowance

Part IV

Please select one of the following and note that council house tenants are NOT eligible under this particular scheme. Your own property Privately rented property
If you are renting your accommodation, rather than being a home owner, please provide the Name Address and Telephone number of your landlord.

Part V

We need the following information to be certain you qualify. Please note, IF YOU DO NOT SUPPLY THIS INFORMATION, YOUR ENQUIRY CAN NOT BE PROCESSED.
Please supply thethe following information:

The applicant's (your own) Name and DOB. Without your DOB, we cannot process the enquiry.

The name and DOB of the oldest resident IF the claim is based on the oldest resident being aged 70 or above

OR/ If you are claiming due to receiving Child Tax Credit, or any benefit due to child under 16, your youngest child's name and DOB

Your name and DOB (Mandatory information)	If applicable, name and DOB of qualifying resident, i.e. youngest child or oldest over 70.
Your Name: Your DOB:	NAME DOB

Type of heating required.

Part VI

In order to process your application, we will need your address and postcode.
If no address and postcode is given, we can NOT process your application.

Postcode

Please tell us your total household annual EARNED income:

Part VII

If you are eligible for the gas central heating grant, you are very lkely to be eligible for 100% funding for cavity wall and loft insulation.

To prevent duplication of enquiries - and possible rejection of both - if you have ALREADY APPLIED FOR A GRANT FOR HOME INSULATION, please leave "None" selected below and click GO. Otherwise please choose one of the following and please do NOT apply elsewhere:

I would also like to apply for:

Loft insulation:

Cavity wall insulation:

Loft & Cavity Wall Insulation:

None:

Finally:

Please supply your contact details and a surveyor will contact you by email or telephone initially. If you do not provide your name or a telephone number, your application will be rejected. Your email address is not mandatory, but will help in the event of being unable to contact you by other means. Many thanks for your enquiry.
Telephone:

Name:

Email:

Mobile: