Greening Wadsworth: Energy Questionnaire 
The Greening Wadsworth group which is part of Wadsworth Community Centre has won a grant from Northern Power Grid Net Zero Fund to find out the current state of energy use and energy efficiency of homes in the Parish of Wadsworth. For this reason, we would be grateful if you could fill in the following questionnaire. 

We would also like to help you understand where you may be losing heat from your house by using a thermal imaging camera to shows cold spots indicating draughts or lack of insulation, for example. This could help you identify some first inexpensive steps towards a more energy efficient home. 

Your information will be used to show us what resources may be needed to help people improve energy efficiency and reduce energy usage and therefore what funding to apply for in the future for the community to make those improvements. 

As a thank you for filling in the questionnaire and agreeing to allow us to assess any heat loss from your property we are offering you a free LED light bulb. 

The data recorded in this will only be shared in an anonymous aggregate way, for example, to understand what percentage of the village has double glazed windows. Your personal information is only used to contact you and to carry out a heat survey if you would like one, explained below. 
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An example thermal image highlighting points of heat loss

When was your house built? If not sure, enter your best guess

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What kind of home do you have?

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What type of house is it?

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Is it... 
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What is your house mainly made of?

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Are your windows…

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Full
Partial
n/a
Single glazed
Double glazed
Triple glazed

How many of your lights are LED?

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What is your main source of heating? (Tick all that apply)

Primary
Secondary
Back up / emergency use
Mains town gas
LPG
Oil
Mains electricity
Wood stove
Coal fire
Dual fuel
Ground source heat pump
Air source heat pump
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Have you installed any energy saving devices? (Tick all that apply)

Do you have any roof insulation? 

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If you have roof insulation, do you know what type and when it was installed? 

Do you have any wall insulation? 

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How old is your boiler? 

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If known, what is your home’s energy efficiency rating from your EPC (Energy Performance Certificate)? 

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If known, what is your annual energy use, in kWh? (This figure is usually given on your gas and electricity bill).

Would you like a free thermal scan of your home? This involves us popping over in the morning or evening to scan for areas of the building where heat is escaping. We have both male and female volunteers doing the scanning, if you have any questions, please ask. As a thank you for completing this questionnaire and agreeing to allow us to assess any heat loss from your property we would like to offer you a free LED light bulb.

Full name
Address
Email

Are you happy for us to keep you updated on advice, tips and news from Greening Wadsworth from time to time? You can unsubscribe at any time. Please note that any personal data you provide will be held securely in line with the Data Protection Act 2018 requirements and only used for the Greening Wadsworth project. 

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