Eligibility Form | Eco Link Solutions LTD

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Eligibility Form

Name *

Full Address *

Postcode *

Contact Number *

Email: *

What is your current tenure? *

Homeowner
Privately Renting
Social Housing Rented

Do You Have A Separate Hot Water Cylinder? *

Yes
No

What Is Your Current EPC Rating? *

A
B
C
D
E
F
G
Unsure

Current Main Heating System *

Gas central heating
LPG central heating
Electric heating
Oil central heating
Renewable heating
Infrared central heating

Secondary Heating System *

Electric panel or oil room heater
Solid fuel fires
Storage heaters
None

Was Your Gas Meter Installed Before March 31st 2022? *

Yes
No

Is The Loft Insulated? *

Yes
No

What Is Your Property Type? *

Detached
Semi-Detached
Mid Terrace
Maisonette
Bungalow
Flat

Does Your Property Have A Loft Or A Room In The Roof? *

Yes
No

What Is the Wall Type? *

Solid brick wall
Cavity wall
Stone wall
Unsure / Other

Is There A Gas Connection To Your Property? *

Yes
No

What Is Your Boiler Type? *

Combi Boiler
Condenser Boiler
1960 to 1980 Back Boiler

What Is Your Current Heating System? *

Electric underfloor heating
Electric storage heaters
Gas central heating from boiler
Gas fire / back boiler
Solid fossil fuel fire / open fire
Bottled LPG Heating
Wood/biomass heating
Oil heaters
No heating in place

Your Option Of Heating With Funding?

High Heat Electric Storage Heaters
First Time Central Heating
Air Source Heat Pumps
Solar PV

Do You Have Any Wall Insulation? *

Filled Cavity
External wall insulation
Internal wall insulation
No insulation / Unsure

Select The Benefit You Are Receiving *

Child Tax Credits (CTC)
Child Benefits - depends on income threshold*
Jobseekers Allowance (JSA)
Employment & Support Allowance (ESA)
Income Support (IS)
Pension Credit Guarantee Credit
Universal Credit (UC)
Warm Home Discount Scheme Rebate
Working Tax Credit (WTC)
Housing Benefit
Pension Credit Saving Credit

Leave this field empty

By submitting this form you are agreeing to receive either a call or E-mail from one of our representatives/consultants to talk through what may be available to you.