Action on Energy - Grant Funding Request Form - Action on Energy Cambridgeshire

Please check if your postcode is eligible?

Please type in your post code with space inbetween: example PE14 9NU.
If your postcode is not automatically eligible please complete the rest of the form and a member of our team will check all other eligibility routes to see if you qualify for grant funding.

What is your full name?

What is your telephone number?

What is your full address?

What is your email address?

Who is your local authority?

Check – Find your local council - GOV.UK (www.gov.uk) if your not sure

Cambridge City Council

East Cambridgeshire District Council

Fenland District Council

Huntingdonshire District Council

South Cambridgeshire District Council

What is the tenure of your property?

Owner Occupier

Privately Rented

Social Housing

OtherOther

What is your council tax band?

Check your Council Tax band - GOV.UK (www.gov.uk)

What is your EPC rating?

Check - Find an energy certificate - GOV.UK (www.gov.uk) if your not sure

What is your property type?

What is the wall construction of your home?

What is your primary source of heating?

What is the approx. age and make of boiler?

If you aren't sure, please just put 'don't know'

Are you connected to the gas grid?

Yes

No

Maybe

Which energy efficiency measures are you interested in?

What is your gross combined total household income? This is your total income before tax.

This is your total income before tax and inclusive of benefits, except for Personal Independence Payment (PIP), Disability Living Allowance (DLA) and Attendance Allowance (AA) as these are not classed as general income

Are you or anyone in the property in receipt of a means tested benefit?

Yes

No

Maybe

Please describe which benefit you receive

Do you or anyone in the property have an illness or disability that is made worse by cold weather?

Yes

No

Maybe

If answered 'yes' or 'maybe', please describe the condition

Have you had any energy efficiency work completed under any grant funding previously?

Yes

No

Not sure

Please view all of our approved contractors for work on our website - Our Energy Efficiency Contractors. Once viewed, please indicate if you have a preference on which contractor may contact you

Where did you hear about Action on Energy Cambridgeshire?

If yes, who was the contractor?

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I consent to the Cambridgeshire local authorities collecting and storing the data provided from this form.

Grant Funding Request Form

Grant Funding Request Form

A Cambridgeshire Councils Partnership

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