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Disabled Facilities Grant (DFG) / Home Adaptation recommendation – Simple adaptation works eForm
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Customer Details
Please provide the below details:-
Title
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First name
mandatory field
Last name
mandatory field
Date of Birth
mandatory field
Date of Birth Day
Day
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Date of Birth Month
Month
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February
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November
December
Date of Birth
Year
Contact number
mandatory field
Alternative Contact Number (If relevant)
Mosaic No
mandatory field
Email address
mandatory field
What we do with your information
We will only use the personal details you provide in order to contact you by letter, telephone or email.
We will not send you emails about other Council services unless you have requested them elsewhere, or share this information with any other organisations unless required to do so in order to provide the service or as permitted by law.
Further information about how we handle your data can be found in our
Privacy Statement
.
Please confirm that you have read and accept this policy
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