HEAT HUB Project Registration Form
Name
*
Title
First Name
Last Name
Date of birth
*
-
Day
-
Month
Year
Date
Address
*
House number or name and street/road
Area
City
County
Postcode
Which of the HEAT Hub services are you interested in?
*
Retrofit Assessment
Future Fit Home Energy Plan
Clean Heat and Power Plan
Boiler Upgrade Scheme
Installer Guidance
Other
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Next
How many bedrooms does your property have?
*
1-4 bedrooms
More than 4 bedrooms
Please confirm that you are a homeowner by selecting the box below:
*
Yes, I am the homeowner and occupier
Yes, I am the landlord
Email
*
example@example.com
Telephone
*
Back
Next
Please select the statement(s) that apply to your home.
*
My home is a listed building and/or in a conservation area
My home is off the gas network
None of the above apply
How do you currently heat your home?
*
Boiler
Community heating
Electric ceiling heating
Electric underfloor heating
Heat pump-wet system
Heat pump-warm air
Room heaters
Storage heaters
Other
Which of the following energy measures have you installed in your home?
*
Cavity Wall Insulation
Internal Wall Insulation
External Wall Insulation
Loft Insulation
Solar Panels
Underfloor Insulation
Air Source Heat Pump
High heat retention storage heaters
None of the above
Other
Which of the following energy measures have you considered for your home but been unable to install?
*
Cavity Wall Insulation
Internal Wall Insulation
External Wall Insulation
Loft Insulation
Underfloor Insulation
Solar Panels
Air Source Heat Pump
Ground Source Heat Pump
First-time double glazing and doors
High heat retention storage heaters
None of the above
Other
If you have been unable to install any of these measures in your home, please tell us why
Please tick the areas or technologies you are most interested in learning about (feel free to tick more than one).
Insulation methods
Solar Technologies
Low Carbon Heating (Air Source and Ground Source Heat Pumps)
Ventilation
Planning permission ( i.e. for listed buildings, homes in a conservation area, heritage sites)
Other
Are you planning building works to your home in the near future?
*
Yes
No
Would you be interested in DIYing some of the work?
Yes
No
Why are you interested in taking part in the project?
*
To make my home more comfortable and healthier
To reduce my carbon footprint
To save money on energy bills
To increase the resale value of my home
Other
How did you hear about Home Energy Advice Team Hub?
*
Google search
Workshop
Social media
Phone call with NEP or MEA
Email
Letter
Leaflet
Event
Other
I agree for H.E.A.T Hub partners to keep my details on their database, and sharing necessary data with 3rd partner agencies involved with providing relevant support.
*
Yes
Submit
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