B&NES Affordable Warmth Grant

Name*
Full Address*
Contact Number*
Email address*
Tenure* —Please choose an option—HomeownerPrivate TenantHousing Association
Is your property listed?* —Please choose an option—YesNoI don't know
Is your property in a conservation area?* —Please choose an option—YesNoI don't know
Do you currently have an EPC?* —Please choose an option—YesNoI don't know
What is your EPC? Please note: IF your EPC is above C then you are unlikely to be eligible for the grant —Please choose an option—ABCDEFG
What measures do you currently have? Please select all that apply* Floor insulationLoft insulationWall insulationDouble glazingSolar panelsLow-energy lighting
Please provide a brief description of what you want installed and why?
Do the works you want completed require planning permission? If you're unsure you can contact the Council's Planning Department on 01225 394041 —Please choose an option—YesNo
When was your house built?*
Are you finding it diffuclt to heat your home?* —Please choose an option—YesNo
What type of property do you live in?* —Please choose an option—TerracedEnd of TerraceBungalowFlatCottageSemi-detachedDetached
Is your household annual income less than £30k? Please note: Households with income above £30k are not eligible for this grant.
We will need to see proof of income in the form of bank statements and/or proof of receipt of means tested benefits.
—Please choose an option—YesNoI don't know
Please provide us with proof of income for the past 3 months and/or proof of receipt of means tested benefits
If you prefer to send this via post, please send to: We Care Home Improvements, 5 Hide Market, Bristol, BS2 0BH
Please provide us with any other information:

Δ