WCDR - Flood Information Sign Up
WCDR will be working to help connect you with available services and programs. By supplying your information below you will allow us to share important information with you about assistance available for your specific situation.

WCDR will be advocating on behalf of all West Carleton's affected residents. It is important to us that agencies who fundraise on your behalf and governments understand the specific impacts in our community and that their programming reflects the actual needs of affected residents.

There are will a variety of support programs that you may qualify for and funds that are available to help in recovery. We will do our best to inform you of all of them and assist with applications as volunteers are available.

If you have any questions please email WCDRFlood2019@gmail.com

First Name *
Your answer
Last Name *
Your answer
Number *
Street Number
Your answer
Street Name *
Your answer
City *
Phone Number *
Your answer
Email
Your answer
Number of Adults in Home *
Your answer
Number of Children Age 0-9 in Home *
Your answer
Number of Children 10-18 in Home *
Your answer
Number of Seniors In Home - 65+ *
Your answer
Number of Household Members with Disabilities or Critical Health Issues *
Your answer
Number of Household Members with Mobility Issues
Your answer
Property Ownership *
If you own more than one property please tell us about them in separate forms.
Status *
Check One
Evacuation Status
Home Based Business
Do you run a business from your home?
Drinking Well Water *
Using Well *
For other purposes. ie bathing, washing etc?
Using Septic System *
Suspected Structural Damage *
Water Damage to Main Living Areas *
Water Damage to Finished Basement *
Water Damage to Unfinished Basement or Crawlspace *
Damage to Home Systems *
Furnace, Hot water heater, etc.
Considering Raising Building to Reduce Risk of Flooding *
Would Be Interested In A Buyout If The Province Offered It. *
Please tell us if you have other issues not outlined.
Your answer
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