Boilers Form

Step 1: Your Circumstances
What is your home ownership status?*
Please explain your home ownership status.
Please select any benefits currently received within the home:*
- Pension credit
- Child tax credits
- Income related employment and support allowance
- Income support
- Working tax credits
- Income based job seekers allowance
- Universal credit
- I do NOT receive any of the above benefits
Date of Birth*
As you are not receiving a qualifying benefit we cannot secure funding for a Gas, Oil or LPG boiler under the ECO scheme rules.
Please click the following link to build you personalised quote
Personalised Quote
For Council and Housing association property applications please contact your management agent or landlord.

Step 2: Your Property
When was your property built (approximately)?*
Please select your property type:*
Unfortunately due to your property type we cannot supply you with a funded boiler
Please select the number of bedrooms:*

Step 3: Your Heating
Please select your current fuel type:*
Unfortunately due to your current fuel type we cannot supply you with a funded boiler
Please click the following link to build you personalised quote
Personalised Quote
When was your existing boiler Installed?*
Is your boiler broken?*
Please choose your boiler:*
- Wall mounted
- Floor Standing
- Back Boiler

Step 4: Your Insulations
Has your property had loft insulation installed in the past 10 years?*
Has your property EVER had cavity wall insulation installed?*
Please confirm that you require any insulation (if eligible).*
- Yes, I do require insulation.
- No, I don't require any insulation