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Please complete all fields marked *
If you would like to nominate a person as your contact for priority services, please tick below.
Home security visit: if you would like us to use a password when we visit you, please enter it below (no more than 10 characters).
Please let us know your reasons for registering ticking all below that are applicable to you or someone in your household:
Please tell us any other reasons: (tick all boxes that apply)
What submitting this form means to you
Terms of registration
By submitting this form you are confirming that you understand we may need to pass details to a third party such as British Red Cross, Local Authority or Emergency Services, in order to provide you with priority services.
We will not use or pass your details to a third party for marketing purposes.
If you have a nominated contact, you are giving your explicit consent for us to talk to your nominated contact on your behalf when providing priority services. This may mean we will share information about you and your electricity supply with them
Sharing your details
With your consent, we can pass your details onto your energy supplier who may also offer services you can benefit from; like a nominee scheme, accessible information and a password protection scheme.