Funeral Grant Application

Please Note

  • Funeral Grant Application.
  • You are required to submit a First Responder ID.
  • Only one award per household.
  • Awards will cover only the following request: Funerals
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.
All information provided on this application will be verified to ensure accuracy and honesty.

General Grant Questions

Please note: 1stRCF defines first responders as police officers, firefighters, emergency medical technicians/paramedics, emergency and ICU medical staff, and employees directly supporting police and fire departments, such as 911 dispatchers. Any other essential workers are not within the mission of our foundation and will, unfortunately, be declined.
What Type of First Responder Are You?*
What is your work status?*
Please select DECEASED if you are applying on behalf of a first responder family member who passed due to Covid complications.
Have you or anyone in your family received a grant from First Responders Children’s Foundation?*

Demographic Information

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.
Name*
Deceased Name*
Home Address of Applicant*

Funeral Information

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.
Is the passing of the family member related to Covid-19 complications?*
Was the deceased a member of your immediate household?*
Have you received assistance from FEMA, or any other financial assistance program?*

Verification

Please submit. Maximum allowed 100MB per file upload; formats allowed (jpeg, jpg, gif, png, pdf, doc). Having problems uploading files? Visit Guide & Troubleshooting
If you are unable to upload all of these documents, please submit what you have at this time.
Max. file size: 100 MB.
(Department ID, EMT ID, Hospital ID; ID must state your name, may have a photo, and shows you are a first responder; Certificate of Training is not a valid ID).
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.

Supervisor Information

Name*
I certify the accuracy of the information provided in this application and in any supporting documentation that I may submit to First Responders Children’s Foundation (1stRCF). I hereby authorize 1stRCF to verify any information disclosed in my application.
I grant permission to discuss PHI in relation to my application with a 1stRCF representative through email and phone. I understand that falsified statements on this application in any detail will be considered sufficient cause for disqualification from further consideration, and 1stRCF shall report the issue to my employer and supervisor.

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