Energy efficiency enquiry form

Complete this form if you are interested in installing energy efficiency measures to your home.

If you are interested in applying for a new boiler or heating upgrade then you must be in receipt of certain benefits so please list all the benefits that you, or any member of your household, receive.

Customer notice: Draught proofing is no longer available as a stand-alone option, please select an additional measure when choosing what services you require.

All fields marked with * are required.
Your details
1. Full name
2. Address line 1
3. Address line 2 (optional)
4. Town/city
5. Postcode
6. Telephone number (optional)
7. Email address
8. Date of birth
9. Any relevant benefits
Please select what measures you are interested in
1. Draught proofing (you must select one other choice as well as this)
  
  Yes
  
  No
2. Draught proofing is no longer available as a stand-alone option, please select an extra option when choosing what services you need.
3. Boiler replacement
  
  Yes
  
  No
4. Boiler service
  
  Yes
  
  No
5. Cavity wall insulation
  
  Yes
  
  No
6. Loft insulation
  
  Yes
  
  No
7. External wall insulation
  
  Yes
  
  No
8. First time central heating
  
  Yes
  
  No
Preston City Council will use your information in a manner compatible with the General Data Protection Regulation (GDPR).

Any disclosures or sharing of information will only take place where required or permitted by law. For further information please see our privacy notice .

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