0800 061 4849 online@qerb.uk
Stay toasty, save money
At QERB Energy, we are working with Wales & West Utilities to help more people enjoy warm, energy-efficient homes across the south west of England.Our Warm Home Assistance scheme is for private householders,  private tenants and tenants who rent from a local authority or housing association. It’s only for properties that have already been built. If you might struggle with the costs of a new gas connection or insulation, we’d like to help

How to apply

  • If you haven’t already got a quote for a new gas connection from us, call us on 01752 546160.
  • Complete and submit the form below and then we will send you your quote shortly after.

Any questions?

If you have any questions about your funding application, QERB are happy to help, so call us on 01752 546160 to speak to one of their team.

Part A

Please tick the appropriate box for each question in part A.

(If yes, you'll need to provide evidence.)

(If yes, you'll need to provide evidence.)

(If yes, please provide evidence of the tenancy agreement.)

(If yes, you'll need to provide evidence.)

For tenants - Please provide us your landlord's name, address and phone number in the boxes below.

How many people live in your home and how old are they?

Person 1

Person 1

Person 2

Person 2

Person 3

Person 3

Person 4

Person 4

Person 5

Person 5

Person 6

Person 6

What is the yearly combined income, after tax, of the people living in your home? (Please include all wages, benefits, pensions, and any interest on savings - after tax and any National Insurance payments.)

Please explain if:

Electricity (economy 7)

Electricity (economy 7)

Oil

Oil

LPG

LPG

Solid fuel

Solid fuel

Wood

Wood

Part B Statement of benefits

Please tick each box if you or your partner claim any of the following benefits (We will need copies of your benefit award letters.)

Part C

Part D

Part E Questions below refer to how you heat your hot water in your house.

Part F

You, the homeowner, should sign this part.

Please remember to read this declaration and sign it. We cannot process the form without a signature.
I give permission for QERB Energy Ltd. and their partners to use the information for reporting to Office of Gas & Electricity Markets (OFGEM) under the current regulations. This information will not be given to other companies or agencies and will be held or used in line with the Data Protection Act 2018.