Name
*
First Name
Last Name
Email
*
Address
*
Please enter your address.
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Size of your property
*
How many bedrooms does your property have?
1-2 bedrooms
3-4 bedrooms
5+ bedrooms
Are you the occupier or landlord of your property?
*
Owner and occupier
Owner and landlord
Is your property listed?
*
Grade I listed
Grade II listed
Grade II* listed
Please tell us about your home, e.g. detached/terrace, rough age and construction, etc.
*
What are you looking to do?
*
Please let us know any energy efficiency measures you have in mind that you would like to implement on your home, e.g. heat pump, secondary glazing, insulation. If you do not know, then please let us know what you are objectives are, e.g. make home warmer, reduce bills, improve comfort.
Roughly, what timescale are you looking to do any improvements over?
Do you have any rough budget in mind for improvements? (You do not have to tell us this if you would prefer not to.)
Is there anything else relevant you would like to tell us about your home and your improvement plans?
Allow us to publish and share a case study outlining the main recommendations made during the survey (this can be anonymised to house type & postcode).
*
Yes
Maybe - please let me know more
No
Participate in follow up questionnaires to provide feedback and testimonial about how you found the process, and to track progress on any measures subsequently installed in your home as a result of the advice received.
*
Yes
Maybe - please let me know more
No
Allow us to publish and share pre-application advice from B&NES Council (this can be anonymised to house type & postcode).
*
Yes
Maybe - please let me know more
No
Ongoing and follow up communication with the B&NES Conservation Officer to monitor the progress of delivery of building works.
*
Yes
Maybe - please let me know more
No
Potentially host monitoring equipment from the University of Bath for a limited time to validate some of the assumptions made in the survey model (such as indoor air quality or moisture levels in elements of building fabric).
*
Yes
Maybe - please let me know more
No
Offer to share information on the case study and your experience through your networks (family, friends, neighbours, colleagues, social media etc).
*
Yes
Maybe - please let me know more
No
Be contacted by our funders the Department of Energy Security and Net Zero, for feedback about your experience.
*
Yes
Maybe - please let me know more
No
Provide a video testimonial
*
Yes
Maybe - please let me know more
No
Write a blog post
*
Yes
Maybe - please let me know more
No
Speak at local event(s) and to neighbours
*
Yes
Maybe - please let me know more
No
Participate in an Open Homes event
*
Yes
Maybe - please let me know more
No
Provide tours of your house for other local residents
*
Yes
Maybe - please let me know more
No
Host ‘House Warming Parties’ e.g. to share findings of your survey with neighbouring residents
*
Yes
Maybe - please let me know more
No
Any comments or questions?
How did you hear about us?
Search engine
Social media
Email
Online advert
Print advert
Referral
Event
Friend/family recommendation
Other (please specify)
Thank you for completing the form. This form is to help us select suitability for a place on this year‘s programme, in the event that demand exceeds the number of places available. Because our funding is limited, priority will be given to people who can support more activities, as well as to those who’re likely to carry out works to their homes sooner.
We will evaluate responses and be back in touch with you soon to let you know the outcome.
If for any reason it isn’t possible for us to accommodate you on this year‘s scheme, or you would prefer not to be a Listed Building Energy Champion, you might be interested in our standalone Home Energy Efficiency Plans or Futureproof Surveys .