Flood Report Form Please use this form to submit incidents of flooding in Southwell to Southwell Flood Forum. Step 1 of 3 33% First Name*Last Name*Date of Incident What would you like to report?Flooding IncidentBlocked drainFlytippingEmail* Mobile no.Phone no. (Landline)Your Information*Your information will help strengthen the funding bid for mitigation measures. I agree to allow Southwell Flood Forum to share the information I submit within this form with the Lead Flood Authority and relevant partners. Your details will not be passed on to any other third party. I would like to subscribe to the Southwell Flood Forum newsletter. Your AddressStreet AddressTown / CityPostcodeWhat was affected? House Garden Garage Outbuildings Car Services (electricity, phone etc) Other What was affected (other)?e.g. ConservatoryApproximately how high was the water inside your home?(measurements in cm)Approximately how high was the water outside your home?(measurements in cm)Are you staying in your affected property?YesNoWhere do you think the water came from?e.g. Was it surface water, river water or sewerage? Overflowing drains, watercourses, hills... Any further detailsInclude any ideas of mitigation or property-level protection measures that may reduce your flood risk. How can you help?Would you like to: be a Flood / Road Closure warden be a Street Representative Other ways you can help: Education Resource Group Fundraising Green Gym Library Help Desk Marketing/Communication/IT Organise a event Publicity Other Can you help in any other ways? Any other comments?
