Please read the below information carefully before completing the application form below.
Connect for Help is a free energy and money saving service that is helping people across England & Wales* to reduce their bills, stay warm and access local support services.
You can apply using the form below either for yourself or on behalf of somebody else. Our Energy Advice Team will get in touch with all applicants to understand their situation, offer initial help and check eligibility for in-depth advice and support.
Eligibility for in-depth support is based on household income, receipt of state benefits, health conditions and family situation. Please complete as much of this form as possible, and our team will then be able to confirm eligibility over the phone.
You can also phone us FREE on 0800 029 4548 or email firstname.lastname@example.org if you have any problems using the form.
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*Connect for Help is focused on supporting households in England & Wales. For help in:
Connect for Help Application Form
This service is delivered by Agility Eco Services Limited, Bierce Surveying and Income Max Community Interest Company and is funded by the Warm Homes Fund. The personal information that we and other relevant organisations may process includes but is not limited to your contact details, information about your property and energy supply and income and welfare benefits.
We will protect and process your personal information in accordance with our data protection policy, a copy of which is available at agilityeco.co.uk/privacypolicy.
Before referring you on to any other service, we will seek your consent. Your personal information will not be used for any other purpose whatsoever.
If you have any difficulty viewing or using the embedded form, click here to access an alternative version. This version may work best for you if you’re using an older web browser or a mobile device. If you have any issues with this please let us know at email@example.com
For more information on how we handle your personal data, please read the Your Personal Data page.