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Free Central Heating -Apply Here

Your Data Will Only Be Used For The Sole Purpose Of Obtaining Government Grants – We Do Not Sell On To Other Parties.

Survey - Central Heating

Step 1 of 13

7%

Have You Had Central Heating Fitted In The Past ?*
- We Do Not Have Central Heating Fitted.
- Central Heating Is Fitted - NOT ELIGIBLE SORRY

Do You Have Any Radiators Fitted?*
- No Radiators Fitted
- Radiators Are Fitted
- A Gas Boiler & Radiators Are Fitted

Which Benefit Do You Receive?*
- Universal Credit
- Pension Credit Guarantee & Savings
- No Benefits - I Am On A Low Income
- Tax Credits
- Job Seekers / Income Support
- Employment & Support Allowance
- Child Benefit

What Is Your Housing Status?*
- Home Owner
- Landlord
- Private Tenant
- Council / Housing Association Tenant
- Shared Ownership

What Is Your Property Type*
- Terraced House
- Semi Detached House
- Detached House
- Semi Detached Bungalow
- Detached Bungalow
- Top Floor Flat With Loft
- Mid / Ground Floor Flat
- Park Home

How Many Bedrooms Do You Have*
- One Bedroom
- 2 Bedrooms
- 3 Bedrooms
- 4 Bedrooms +

What Is Your Main Home Heating*
- Electric Storage Heaters
- Gas Boiler & Radiators
- Gas Back Boiler
- LPG Heating
- Oil Heating
- Warm Air System
- Solid Fuel / Coal Fire
- No Heating System Present

Which FREE Insulation Do You Require*
- Whole House Check Required.
- My Home Already Fully Insulated

Do You Have a Gas Meter Fitted ?
- Meter Is Fitted
- No Meter Is Fitted
- Unsure

Please Enter Your Postcode*
Ist Line Of Address*

Applicants Full Name*
Applicants Date Of Birth*

Your Phone Number*
2nd Phone Number OR Email Address*

Best Time To Phone You To Book Your Free Survey*
- Morning
- Afternoon
- Early Evening
- Any Time
GENUINE APPLICANTS ONLY PLEASE Please do not submit this form if you never answer your phone.

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