Eligibility Form boiler form Are you a Home owner or Private Tenant?(Required) Home Owner Private Owner Only home owners are eligible for Boiler Grants.Are you someone from the household claiming any sort of benefits?(Required)Income Based Jobseeker's allowance (JSA)Income Related Employment & Support Allowance (ESA)Income SupportPension CreditHousing BenefitPension Savings CreditWorking Text CreditUniversal CreditChild Text CreditWas your boiler installed before 2005? Yes No No Boiler & Radiators Only home owners are eligible for Boiler Grants.How is your home heated?Warm Air Heating UnitImmersion heater tanksElectric blow heatersElectric storage heatersElectric Room HeatersElectric wall air systemsCoal FireLog burnerOther Solid Fossil FuelIs there a gas meter installed in the property? Yes No Full Name(Required) Phone(Required)Email(Required) Post Code(Required) Address(Required) Full Name(Required) Phone(Required) Email(Required) Post Code(Required) Address(Required)
