Grants and housing assistance enquiry form To register for grants or housing assistance, please fill in the form below. Your details Full name Full address including postcode Phone number Email address (optional) Are you filling this form in for someone else? Yes (optional) No (optional) Resident's details If you are filling this form in for someone else, please let us know the details of the person who requires a grant or housing assistance. Full name Full address including postcode Phone number Email address (optional) Please select the type of property - Select -Privately rentedOwner-occupiedHousing associationCouncil tenant Please let us know the reason for your request - Select -I have difficulty climbing my stairsI can’t get in my bath anymoreMy front door does not secureMy home is cold and draughtyI have no heatingI need some small repairs done in my propertyMy heating bills are highMy heating has broken downI have no hot waterOther, please specify Please provide further details Is anyone in the household under 5 years old or over 65 years old? Under 5 years old (optional) Over 65 years old (optional) CAPTCHA Read our data protection notice to learn about how the council complies with data protection laws when processing your data. Submit
