ECTC Better Energy Scheme - Householder Interest Form
In order to take part in this scheme, please take some time to answer the following questions.
This Interest Form will help your local ENERGY TEAM and Energy Communities Tipperary Co-operative (ECTC) to assess your eligibility to take part in the scheme. For further information, please contact your local Energy Team or email project co-ordinator Marcella Maher Keogh on energycommunitiestipp@gmail.com
This form can be shared using this short link: www.bit.ly/ectform2 This scheme is run by ECTC, a local not-for-profit cooperative, with a voluntary board of directors, as a tool to stimulate the local economy, make our homes more comfortable and efficient; and save people money.
NOTE: for Fuel Disadvantaged homes - proof of payment documents must be emailed or posted to the Energy Co-ordinator before your application will be accepted. Email: energycommunitiestipp@gmail.com Marcella Maher Keogh, Carrick, Drom, Thurles, Co. Tipperary. Please note the documents required for question 7 below. For more information about ECTC see our blog on www.energycommunities.wordpress.com
1a) Please enter your Name, Address, and Eircode here *
Your answer
1b) Please enter your Phone number here (mobile preferably) *
Your answer
2) Please enter your MPRN number – this number is usually located on the top right corner of your Utility Bill *
Your answer
3) In what year was your house built? (Approx)
Your answer
4) Are you the owner of this dwelling? or are you renting the property?
Your answer
5) What type of dwelling do you live in?
(Please Tick)
6) Is your home a listed building? And what is the approximate size of your home?
Answer: Listed. Not Listed. Give area in square meters or square feet.
Your answer
7) People in receipt of Department of Social Protection supplements may be entitled to a higher level of grant aid. Please tick which supplements you are in receipt of.
NOTE proof of payment documents must be emailed or posted to the Energy Co-ordinator before your application will be accepted. Email: energycommunitiestipp@gmail.com Marcella Maher Keogh, Carrick, Drom, Thurles, Co. Tipperary 1. Fuel Allowance as part of the National Fuel Scheme - Provide one of: I. Signed letter from Department of Social Protection confirming fuel allowance; II. Social welfare payment receipt which indicates fuel allowance payment; or III. Receipt from use of social welfare swipe showing receipt of fuel allowance 2. Job Seekers Allowance for over six months - please provide letter from Department of Social Protection confirming receipt of job seekers allowance for 6 months or more and confirming children in the home. Note: Jobseekers Benefit is not an eligible allowance. 3. Family Income Supplement (FIS): - provide Letter from Department of Social Protection confirming receipt of Family Income Supplement or II. Proof of receipt of payment
8) Insulation is a cost effective way of reducing your energy bills. Does your house have insulation? When was it installed?
Your answer
9) Have you already availed of an SEAI energy efficiency scheme?
Yes or No. If Yes please state when and what work was carried out
Your answer
10) (Please tick at least three of the options below) Which insulation/energy efficiency measures would you like to have carried out on your homes? *
This is expression of interest only. Before proceeding, each householder will have an opportunity to speak with an Energy Advisor/Building Energy Assessor to assist them in selecting energy efficiency measures that suit their needs and budget.
Required
11) QUESTION ONLY FOR HOUSEHOLDERS NOT ON FUEL ALLOWANCE - If you were to upgrade your home, how would you finance 65% of the cost (grant would cover 35%)?
12) Personal Data Protection:
I consent for my data to be used by Energy Communities Tipperary Cooperative for the following purposes: to administer and deliver the 2017 Better Energy Communities Scheme; to determine and verify grant eligibility; and to assist in the calculation of credits for energy suppliers.
13) How did you hear about the scheme? (If from a personal contact, please give name of person in the "Other" column)
Any other comments?
Your answer
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