Flood Kit - Online Request Form

Building Flood Kit will be used / stored in*

Area / Floor / Room where Flood Kit will be used*

Is this a problem area that is prone to flooding?*

If this is a continuous problem, please let us know so that we can potentially look at a solution.

Select or enter value

Urgency of the Flood Kit Request

Deliver Soon

Requester's Name*

Requester's Email*

Please use your @lsu.edu email address

Requester's Phone Number

Please use your LSU phone number if possible

Requester's Department*

Cost Center

This is used for tracking purposes only. No cost will be passed to departments for utilizing the Flood Control Kit Program.

Select

Building / Room # for Delivery*

Maximum # Per Request

Flood kit requests will be limited to 5 between Large and Small unless justification is provided.

# of Large Kits - Buckets*

Large Kits come in a 5 Gallon Bucket with a removable lid. They include 8 flood barriers and 3 poly tarps.

# of Small Kits - Bags*

Small Kits come in a 2 Gallon Bag. They include 3 flood barriers and 3 poly tarps.

Any comments or additional information?

Data Authorization*

I authorize that all information provided on this form, including any and all personal, financial and academic data may be shared with the LSU Risk Management and university insurance carriers and vendors. This data will be securely retained indefinitely. To learn more about privacy at LSU, please see the LSU Privacy Statement - https://www.lsu.edu/privacy/

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