JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
January 2024 Flood Impact Survey
The Whatcom Long Term Recovery Group is currently collecting information regarding the January 2024 flooding. Please complete the form below.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Contact Phone Number
*
Your answer
Contact Email Address
Your answer
Impacted Address (# and street name)
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Type of Dwelling
*
Primary Home
Secondary Home
Apartment
Mobile Home
Travel Trailer/RV
Business
Other:
Homeowner or Renter?
*
Homeowner
Renter
Description of Damages
*
Your answer
Estimated Loss Amount (in dollars)
*
Your answer
My answers reflect January 2024 flooding impact only
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
