2025 Bereavement Assistance Application

Bereavement Assistance

The Bereavement Assistance Grant honors those lost in the line of duty by providing financial support and the comfort of a community to the family of the fallen hero. This grant awards $5,000 to assist the family with bereavement costs and financial hardship following the loss of their loved one.
PLEASE NOTE:
- Only one award per household will be remitted.
- FRCF defines first responders as police officers, firefighters, emergency medical technicians/paramedics, and 911 dispatchers/communications. Any other essential workers are not within the mission of our foundation and will, unfortunately, be declined.
- The fallen hero should have had children under the age of 18 at end of watch to be eligible.
- All information provided on this application will be verified to ensure accuracy and honesty. Falsified statements or documents in any detail will be considered sufficient cause for disqualification. FRCF will report the issue to your employer/supervisor and fraud will be prosecuted to the fullest extent of the law.
- FRCF does not and shall not discriminate on the basis of race, color, religion, gender, gender expression, age, national origin, disability, marital status, or sexual orientation in any of its activities or operations.
Primary Contact

Please provide up-to-date contact information so that we may reach you if we need more information.
Full name*

First NameLast Name
Phone number*
Please enter a valid phone number.
Email*

Confirmation Emailexample@example.com
Preferred method of contact*

Phone callEmailText message
Is the first responder hero a member of your immediate household?*
Your relationship to the fallen*
First Responder

Please fill out the following, to the best extent you can, about the fallen first responder hero for whom you are applying.
Full name*

First NameLast Name
Badge/ID number*
Agency or affiliation*
Home address*

Street Address

Street Address Line 2

CityState

Zip Code
Kind of first responder*
First responder's work status*
Please provide a brief job description*
Hero's end-of-watch*

MonthDayYear
Date
Please describe the circumstances surrounding the line of duty death*
Supervisor's full name*

First NameLast Name
Supervisor's phone number*
Please enter a valid phone number.
Supervisor's email address*
example@example.com
Document Uploads

Please note that all submissions will be verified to ensure accuracy and honesty.
First responder's ID badge or proof of employment

If submitting proof of employment, please include it on official letterhead from the affiliated agency
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Funeral bill and other associated expenses

Cancelof
Certificate of death

Cancelof
Photo(s)

Although it is not required, if you would be willing to share photos of your family that includes your first responder hero, please upload them here
Cancelof
Survey

Please answer a few additional questions about the first responder.
Is the passing of the hero related to COVID-19 complications?*
Have you received assistance from PSBO or any other financial distress program?*
Are you willing to be contacted by a First Responders Children’s Foundation staff member to share your story?*
Gender of first responder*
Hero's age at end-of-watch*
How many children under 18 did the hero support?*
What are their ages and genders?*
If none, just enter N/A
Was the first responder hero a single parent?*
Was the first responder hero, or surviving spouse, a veteran or active military?*

YesNo
How would you describe the hero's race/ethnicity?*

Hispanic, Latin, or Spanish originAmerican Indian or other Native AmericanAsian or Pacific IslanderBlack or African AmericanMiddle EasternWhite/CaucasianOther/prefer to self-describe
How did you hear about this program?*
Please describe
Your Story is a Lifeline for Others

When you receive support from First Responders Children’s Foundation, you become part of a mission bigger than any one of us. The generosity that helps your family today exists because others before you shared their stories—stories of resilience, sacrifice, and hope. Now, it’s your turn.

By sharing how this grant impacts your life, you help us raise critical funds to support more first responder families just like yours. Your words inspire donors, open doors to new resources, and ensure that when the next family is in need, we’re ready to stand with them—just as we stand with you.

This isn’t just storytelling. It’s paying it forward. It’s making sure no first responder’s family stands alone.

If your grant application is accepted and awarded, we will be in touch with a request to share your story.
Should be Empty:

Bereavement Assistance

Primary Contact

First Responder

Document Uploads

Survey