Cheshire East Council FLEX Application

ECO4/GBIS Flexible Eligibility Application Form
Password*
Applicant Details
Title*
Name*
Date of Birth*

DayMonthYear
Date
Address inc. Postcode*
Telephone*
Email*
example@example.com
Who else lives in your home with you?*
List all the names of ANY occupants. Separate the names with a comma. Write N/A if the property is only occupied by the applicant
Who else (if anyone) owns your home with you? Or, who is your landlord?*
Write N/A if the property is only owned by the applicant
Tenure*

HomeownerPrivate Tenant
EPC Rating*

EFGUnknown
Which FLEX qualifying route?*

Route 1 - household income less than £31,000 before taxRoute 3 - NHS referral
Route 3 - NHS Referral Health Condition Category

CardiovascularRespiratoryLimited MobilityImmunosuppression
Dropbox Folder
Should be Empty:

ECO4/GBIS Flexible Eligibility Application Form