If you are a private landlord and wish to apply you can download an assessment form to print, or request an assessment form to be posted to your address. Please click the relevant link.

Once you have printed or received your self-assessment form, simply fill it in, sign it, and send it back to us through the post at the following address: North Staffordshire Warm Zone, Initiative House, Campbell Road, Stoke-on-Trent, ST4 4DE

Please attempt to answer all the questions; some have a 'don't know' option. The information will be used to assess the energy efficiency of the housing stock in your area.

We require your contact details, signature, and property details to process your application. Failure to provide this information could prevent you from receiving free loft and cavity wall insulation.