***** FIRST RESPONDER Family Application *****
To Join W-A-T-C-H, please complete ALL information below. W-A-T-C-H (We Are The Children of Heroes) is a program for the children (and their surviving parent) of fallen first responders or families of fallen military who wish to support them. We host programs for children and widows/widowers of those men & women who have given their life while serving our communities as Police, Firefighters, EMS personnel.
Who Can Join:
FIRST RESPONDER FAMILIES: The widow/widower (or guardian) with children of a First Responder who was killed/died (post 9/11) while serving as a first responder, or who died from injuries sustained while serving as a first responder should complete the short below. Should you have questions, please send them to WATCH@1tribefoundation.org.
Please check to verify. We are the family of a:
Fallen FIRST RESPONDER
Parent / Guardian Information
*
First Name
Middle Name
Last Name
Suffix
Gender
*
Female
Male
Date of BIRTH
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Mobile Phone Number
*
-
Area Code
Phone Number
Home Phone Number (if different)
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next: Add Child /Children's Information
Children's Information
Name of Child # 1
*
First Name
Middle Name
Last Name
Suffix
Child #1 Date of BIRTH
*
-
Month
-
Day
Year
Date
Child #1 Gender
*
Female
Male
Child #1 Age
*
Child #1 favorite activities, subjects, or any development needs
*
Such as: Music, art, hiking, fishing, camping, horses, science, reading, writing, poetry, etc
Name of Child # 2
First Name
Middle Name
Last Name
Suffix
Child #2 Date of BIRTH
-
Month
-
Day
Year
Date
Child #2 Gender
Female
Male
Child #2 Age
Child #2 favorite activities, subjects, or any development needs
Such as: Music, art, hiking, fishing, camping, horses, science, reading, writing, poetry, etc
Name of Child #3
First Name
Middle Name
Last Name
Suffix
Child #3 Date of BIRTH
-
Month
-
Day
Year
Date
Child #3 Gender
Female
Male
Child #3 Age
Child #3 favorite activities, subjects, or any development needs
Such as: Music, art, hiking, fishing, camping, horses, science, reading, writing, poetry, etc
Name of Child # 4
First Name
Middle Name
Last Name
Suffix
Child #4 Gender
Female
Male
Child #4 Date of BIRTH
-
Month
-
Day
Year
Date
Child #4 Age
Child #4 favorite activities, subjects, or any development needs
Such as: Music, art, hiking, fishing, camping, horses, science, reading, writing, poetry, etc
Name of Child # 5
First Name
Middle Name
Last Name
Suffix
Child #5 Gender
Female
Male
Child #5 Date of BIRTH
-
Month
-
Day
Year
Date
Child #5 Age
Child's favorite activities, subjects, or any development needs
Such as: Music, art, hiking, fishing, camping, horses, science, reading, writing, poetry, etc
Back
Next: Add Fallen Hero's Information
Fallen Hero's Information
Fallen Hero's Name
*
First Name
Middle Name
Last Name
Suffix
Hero's Gender
*
Female
Male
First Responder Type
POLICE
FIRE
EMS
STATE Agency
FEDERAL Agency
Cause of Death
Assault
Gunfire
Automobile/Motorcycle
Drowning
Heart Attach
Suicide
9/11 Related Illness
Training
On-Scene Fire/Rescue
Other
Hero's Employing Agency
*
EXAMPLE: Dallas Police Department, Texas Rangers,
Hero's End of Watch Date
*
-
Month
-
Day
Year
Date
Badge ID#
Rank
Hero's Date of BIRTH
*
-
Month
-
Day
Year
Date
Was this Fallen Hero a Military Veteran
YES
NO
If so, please list Branch of Service
Army
Navy
Marines
Air Force
Coast Guard
How did you hear about W-A-T-C-H?
Name of person or group. Received information at meeting, etc.
Have a Question, please submit here. Thank You.
If you have a favorite photo of your hero alone or with you and family that you would like used to remember and honor his/her service and sacrifice, please attach/upload it to us here.
Attach & Upload Here
Click to attach Photo here. Don't forget to click SUMBIT below when you are done . By uploading the photo(s), I hereby grant permission for 22KILL / WATCH Program to use the photograph(s) and include it/them in their Heroes Honor Book, social media and publications, online, and in other communications related to the mission of honoring America’s fallen first responders and military.
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of
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