PLEASE DO NOT COMPLETE THIS APPLICATION FORM - IT IS NO LONGER ACTIVE

COMPLETE THE FORM AT THE FOLLOWING LINK INSTEAD:

Apply for a grant

Please tell us your title

Mr Mrs Miss Ms Dr Rev Prof

Your first name*

Your surname*

Please enter your postcode below and look up the address of the property which requires the works

Address*

Address Line 1

Address Line 2

City

County/Region

Postcode

IMPORTANT: Please provide us with either a day time phone number or email address or ideally both

Landline number

Mobile phone number

Your email address

Which works are you interested in? (Tick as many as you like)

Cavity Wall Insulation Loft Insulation Boiler upgrade to renewable heating Central heating installation Air source heat pump Solar PV (electric) Solid wall insulation Flat roof insulation

Other:

If you are interested in getting a grant for your work, you can speed up the process by answering some more questions

Yes I am happy to do this

If you do not want a grant or just want us to call you, please submit the form now

If you receive Child Benefit your household income before tax and including any benefits must be below the figures as below (see here for more information)

Please list any other benefits you receive that are not shown above

Are you the person in receipt of benefit?

Yes No it is someone else in the house

First name of the person on benefit

Surname of the person on benefit

Date of birth of the person who is on benefit

Do you claim your benefit as a single person or a joint claimant with a partner?

How many dependant children live with you?

Roughly what is your annual household income after tax and national insurance?

Even though you do not receive the benefits above, answering these questions may help us to get you a grant

Roughly how much do you spend on council tax payments a year?

Roughly how much do you spend a year on all of your energy/fuel bills?

Do you own or rent your home?

Do you know what your home's energy performance certificate (EPC) rating is?

If you do not know what your EPC is, you can look it up by clicking here and typing in your postcode. If you property does not have an EPC please select "Not Available"

We will need your landlord's permission to carry out any works, would you like to give us their contact details now or later?

I will give you my landlord's details now Later

We will email the landlord to request written permission to carry out the works

Landlord or letting agent name

Landlord or letting agent email address

Landlord or letting agent daytime contact phone number

What is your property type?

How many external walls does the flat/maisonette have?

What type of walls does you home have?

How many bedrooms does your home have?

What is you current form of heating

How did you hear about us?

Please tell us a little more about how you heard about us - E.g mailing code or name of newspaper etc

Your mail shot would normally have contained a code such as "West Devon Gas 19-03". Or if if you saw an article in a newspaper, or on a website, please tell us which one

Please select the name of your local authority from this list if you know it

Please tick to confirm you and, if applicable, the person who is on benefit named above, have read and agree to our data statement below*

Yes I (or we) have read the statement below and agree for you to share my (our) data for the purposes of my works or grant (if applicable)

Privacy Notice: Please note, by applying for a grant, we will share your data as per the privacy notice below. In most cases your data will be processed for the purposes of our legitimate interest in delivering the contract of works, which does not require your explicit consent. However, in some cases, in order to confirm your eligibility, we may be required to collect and process special category data, such as information about any illnesses you or someone in your household may suffer. In these cases, we will take your consent as provided above, to be valid for at least 7 years, which is the minimum that may be required to enable your grant to be provided. By ticking the box, you are therefore confirming that you provide your consent, where it is absolutely necessary, and that this will not be retracted within 7 years.

How we use your data: Happy Energy Solutions Ltd will only ever use your data in relation to your request for works or application for a grant, we promise that we will not sell or provide your data to third parties for any other reason. In order to offer you the lowest cost for your works and maximum grant, we will want to check that you are eligible for the Energy Company Obligation (ECO), so we will need to share your data with a range of organisations which may include your local council (who may have further grant funding available or who may be able to authorise your eligibility for the ECO Scheme) and if you are on benefit, we may also ask The Department of Work and Pensions about this. Do you agree that we may: 1) Share your details with our service provider Energy Saving Trust so they can check if you may be eligible for this assistance and provide services to us. 2) Get in touch with the Department for Work and Pensions via the Energy Saving Trust to check if you may be eligible for this assistance. 3) Receive information from the Department for Work and Pensions about you, this will be limited to information relating to your entitlement to assistance. 4) Share your details with the scheme administrator, Ofgem, so they can review the scheme. 5) Share your data with your local council if needed to obtain grant funding for your home. 6) Share your data with all organisations needed to progress your works or grant which may include installers, technical monitoring inspection companies, third party surveying companies, manufacturers of equipment for warranty registration or design services, companies providing other certification services or deposit protection schemes, companies that provide our secure data systems and software, energy companies or third party organisations/charities who may provide grant funding, your landlord or letting agent if you rent your property, material suppliers for delivery of products