To help us identify if you are eligible to grant funding for home insulation/heating please tick any of the relevant boxes below:

• Pension Credit
• Child Tax Credit (Where Income is Below £15,860)
• Employment Support Allowance (With either a Child Under 16, Child under 20 in further education, Disability Element or Pension Element)
• Job Seeker’s Allowance (With either a Child Under 16, Child under 20 in further education, Disability Element or Pension Element)
• Income Support (With either a Child Under 16, Child under 20 in further education, Disability Element or Pension Element)
• Working Tax Credit Where Income is Below £15,860 (With either a Child Under 16, Disability Element, Pension Element or if you are aged 60 or over)