BRG WHD Dec Form | British Gas Warm Home Discount

All questions marked with * are mandatory

Title*

First Name*

Surname*

Address*

Telephone Number*

Email

Is your electricity supplied by British Gas or Sainsbury's Energy?*

Yes
No

Electricity Account Number*

Faux-Hidden*

Please note to be eligible for a payment from British Gas / Sainsbury’s Energy you must have an active electricity account with them