Please
fill in the form below and click the submit button to send it to the Cheshire
and Merseyside Energy Efficiency Advice Centre. We will send
you a free home energy action pack with details of what grants you are entitled
to and how you could save money on your fuel bills.
Q1) What is your property
type?
Q2) What type of home
do you live in?
Q3) Approximately when
was your home built?
Q4) Is your home owned
or rented?
Q5) Does your home have
a heated conservatory?
Q6)
How many rooms (Bed,
living, dining) does your home have?
(include hall, stairs and landing as one room)
Q7) How many storeys
does your home have?
(for flats and maisonettes only include your home not the whole block)
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Q8) Does your home have a garage
built into the house
IF YOU LIVE IN A FLAT
Q9) Is your flat
in a:
Q10) Where is
your flat positioned in the building?
Q11) How many
walls of your flat are fully exposed to the outside?
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Q12 What type of
walls do you have?
Q13) How much loft insulation
do you have?
Q14) How much of the
property is double glazed?
Q15) Are the single
glazed windows draught-proofed?
Q16) How many open fireplaces
with chimneys do you have?
No of open Chimneys
Q17) How many of your
lights have low energy light bulbs fitted?
Q18) Are you thinking
of buying a new electrical appliance for your home in the near future?
Q19) What is the main
fuel used for heating your property?
Q20) What is your main
heating system?
IF
MAIN HEATING SYSTEM IS A BOILER
Q21a) When was your boiler installed?
Q21b) What type
of boiler does your property have?
IF MAIN
HEATING SYSTEM IS STORAGE HEATERS
Q22) What type
of storage heaters are there?
IF MAIN
HEATING SYSTEM IS ROOM HEATERS
Q23) What type
of room heaters are there?
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FOR ALL HEATING
SYSTEM TYPES
Q24) What type of heating
controls do you have? (please select all that apply)
Q25) What is your secondary
heating fuel?
Q26) What type of secondary
room heaters are there?
WATER HEATING
Q27) How do you heat your hot water?
Q28) What is the size
of your hot water cylinder?
Q29) Is your hot water
cylinder insulated?
Q30) Is there a thermostat on the water cylinder?
Q31) Is solar water
heating present?
GRANTS
You may be entitled
to a grant if a member of your household is over 60 or in receipt of benefits
Is a member of your household:
Q32) Aged over 60
Yes
No
Q33) Receiving benefit
Yes
No
(If Yes please specify benefit type)
Thank you for
filling in the survey form.
Please fill in your details below and send the form using the "Submit"
button.
NB: Please complete
ALL the boxes below.
You will receive a free home energy action pack, learn what grants you are
entitled to and how you could save money on your fuel bills.
Address
Postcode
Telephone
E-mail
The Energy Saving Trust (EST) is collecting your data for the purpose of
providing you with energy efficiency advice, taking the form of a personalised
report and follow up consultations where appropriate, that will help you
reduce your energy use. EST will retain your data for the purposes of carrying
out research and statistical analysis into the energy efficiency of UK housing
stock. Your local Energy Conservation Authority will also receive your data
for the purposes of energy efficiency monitoring, targeting and reporting.
In future, EST may wish
to send you further information including details of grants, special promotions
and free offers which can save you money on your energy bills. If you are
happy to receive this help, please tick here:
Yes
No