Individual Financial Hardship Assistance

Please Note

  • Only one award per household will be remitted.
  • Awards will be based on dire financial need related to housing distress, extenuating childcare/eldercare expenses, and medical and/or mental health expenses related to your first responder position.
    • If your financial distress is related to Covid-19, please describe the pandemic’s influence using the Impact Statement section of this application. For example, being hospitalized due to Covid-19, income loss due to Covid-19 illness, etc.
  • The following documents are REQUIRED to be attached for your application to be processed:
    • First responder ID, or a signed letter from your employer on company letterhead stating your employment.
    • Proof of financial distress that includes your name and an invoice date, i.e., medical bills, childcare bills, past due housing/utility bills
  • Medical personnel are defined as those directly treating patients in an emergency setting.
  • 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.

Personal Information

Name*
Home Address of Applicant*

Supervisor

Please provide a direct line to your supervisor at your agency/place of employment. Cell phone numbers are not acceptable.
Name*

Grant Questions

Has anyone in your family received a grant from First Responders Children’s Foundation?*
Have you previously submitted an application to First Responders Children’s Foundation?*
Gender*
Are you of Hispanic, Latin, or Spanish origin?*
What kind of first responder are you?*
Have you previously submitted an application to First Responders Children’s Foundation?*

Verification

Max. file size: 256 MB.
(First responder ID, or a signed letter from your employer on company letterhead stating your employment)
Max. file size: 256 MB.
(Proof of financial distress that includes your name and an invoice date, i.e., medical bills, childcare bills, past due housing/utility bills)

Impact Statement

Please describe your financial hardship including explanation of child or elder-care related expenses, rent/utility bills, hospital bills, mental health expenses, or loss of home. If your financial distress is related to Covid-19, please elaborate.
Your Impact Statement must be written in your own words. Falsified or plagiarized statements on this application shall be considered sufficient cause for disqualification from further consideration.

Supervisor Information

Have you received assistance from FEMA or any other financial assistance program?*
Are you willing to be contacted by a First Responders Children’s Foundation staff member to share your story?*
I have been honest of my need, statements, and documentation in this application*
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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