Apply for two free light bulbs - UK residents only
 
Please complete the following form. Items marked with an * are mandatory
 
Title*
First name*
Last Name*
Address 1*
Address 2
Address 3
Town
County*
Postcode*
 
Phone number
Email address
 
I am in receipt of the following benefit or over 70 years old: *
I am over 70 years of age
Council Tax Benefit
Housing Benefit
Income Support
Income-based Job Seeker's Allowance
Attendance Allowance
Disability Living Allowance
Disablement Pension which includes constant attendance allowance
War Disablement Pension which includes either a mobility supplement or constant attendance allowance
State Pension Credit
Child Tax Credit where relevant income is 15,592 or less
Working Tax Credit where relevant income is less than 15,592 or less
    

Terms and conditions
In filling in the on-line form and declaration you acknowledge that your details will be forwarded to The Grass Roots Group UK Limited, Tring, Hertfordshire. We will ensure that your data is processed in accordance with the data Protection Act 1998. The Grass Roots Group UK Limited or E.ON reserve the right to change or withdraw this offer at any time. This offer is subject to availability and due to high demand there may be a delay in dispatch. We endeavour to send your lightbulbs as quickly as possible. Thank you for your patience. Only one pack of Free light bulbs per household. Offer available to residents of Great Britain only.