Financial assistance is provided to the families of public safety officers and firefighters upon death or serious injury*; aid is also extended to officers and firefighters who are called to active duty military. Assistance is extended to volunteer and/or reserve officers/firefighters only when the incident occurs while he/she is on duty. To request assistance for a public safety officer or firefighter, the appropriate form must be completed by a supervisor or by human resource personnel. Potential beneficiaries are not authorized to submit requests. If you have questions, please feel free to call our office at (602) 485-0100.
Please use the links to the right to fill out the appropriate request form. If you are not contacted by a 100 Club of Arizona representative within 24 hours after submitting your request, please call our office at (602) 485-0100 to verify that your paperwork has been received.
WE OFFER ASSISTANCE IN CASE OF:
LINE OF DUTY DEATH
$15,000 one-time assistance
ON DUTY* DEATH
$10,000 one-time assistance
NON-LINE OF DUTY DEATH
$5,000 one-time assistance
LINE OF DUTY INJURY*
$500 per month based on need
ON DUTY* INJURY
$500 one-time assistance
Line of duty death/Non-line of duty death assistance request form
Line of duty injury assistance request form #1
Please use this form when submitting your first request for Line of Duty Injury benefits
Line of duty injury assistance request form continuing
(for request #2-12)
H.E.R.O.S./Special needs request form
Please complete this form if suggested by a 100 Club representative
SAFETY ENHANCEMENT STIPEND
The 100 Club of Arizona’s Safety Enhancement Stipend (SES) program was created in 2004 to provide assistance to public safety agencies for equipment to enhance the safety of officers and firefighters. The SES Program allows agencies to obtain equipment and training that is otherwise unavailable through other funding. Arizona’s first responders run head first into danger to protect our communities; we want to help protect them while they do that. The Safety Enhancement Stipend program gives agencies the opportunity to obtain crucial safety equipment to keep their first responders safe. In 2016, the Safety Enhancement Stipend program provided $172,040 in safety equipment to public safety agencies in need. We look forward to providing more assistance throughout the years to Arizona’s public safety agencies to enhance the safety of our officers and firefighters.
2018 ASSISTANCE PROVIDED:
March 15, June 15, September 15, December 15
SAFETY ENHANCEMENT STIPEND POLICIES AND APPLICATION PROCEDURES:
- Safety Enhancement Stipends will be awarded on a quarterly basis.
- The value and number of awards will be determined by the 100 Club of Arizona Board of Directors.
- All city, county, state, federal and tribal public safety agencies in the state of Arizona are eligible to apply for SES funds.
- There are no restrictions on the number of times an agency can apply for a Safety Enhancement Stipend. Any agency that receives a SES award is asked to wait one quarter before reapplying.
- All requests must be submitted to the 100 Club of Arizona via the SES-Request-Form.
- All requests must come from the department head of the requesting agency or a designee.
- A minimum of two quotes is required and must be submitted in writing. Please include the two quotes with the application.
- Quotes must be on approved letterhead from a vendor and must meet the specifications of the applying agency.
- If two or more quotes are equal, then a recommendation from the department head is requested.
- An up-to-date department W9 must be attached to the SES submission.
- All purchased equipment will be the sole property of the agency receiving the equipment and is not to be owned by any individual public safety employee.
- All purchased equipment must be used solely for the protection of public safety officers or firefighters.
- All purchased equipment is not to be sold by the receiving agency without the written approval of the 100 Club of Arizona.
- All requests must be received by 5 p.m. on the dates listed below. Faxed or emailed applications will not be accepted. Requests should be mailed or hand-delivered to the 100 Club of Arizona.
Upon approval, agencies will receive guidelines for purchasing approved safety equipment.
Award Questionnaire for SES recipients:
**Agencies that have already been awarded with a Safety Enhancement Stipend are required to fill out the SES Questionnaire Report. Safety Enhancement Stipend Program Questionnaire must be filled out by December 31 of the awarding year and is mandatory prior to applying for future SES awards. Please fax or email the report to Patti Ballentine at firstname.lastname@example.org or 602-242-1715. We encourage you to please send photos of your officers and firefighters in action using their new equipment!**
A very special thank you to Valley Toyota Dealers who have generously donated $100,000 in 2018, 2019 & 2020 for additional Safety Enhancement Stipends to be awarded in Maricopa County.
Tragedies occur in the lives of Arizona’s public safety officers and firefighters every day; many times these tragedies have nothing to do with their career in public safety. The 100 Club of Arizona coordinates available resources with the needs of public safety families through our Helping Emergency Response Officers and Survivors (H.E.R.O.S.) and the Special Needs programs.
Special Needs Program - When an officer or firefighter’s family has a special need due to a serious on duty injury*, or a first responder needs funding for emergency travel, lodging or other special needs identified by the agency.
*A serious injury is defined as a wound or condition of the body caused by either external forces or by physical strain which requires a minimum of 30 days off duty. Serious injury does not include emotional stress.
H.E.R.O.S. (Helping Emergency Response Officers & Survivors) – When an officer or firefighter is affected by a terminal illness, the loss of a spouse or child, or a tragic life altering event.
- These additional resources are available to public safety and their families. These resources are free of service and are unaffiliated with any particular agency.
- Firestrong.org– Fire Strong is an organization comprised of tools and programs designed by members for members and is completely confidential and anonymous.
- Fire Crisis Support Line: 602-845-FIRE (3473) – An independent, confidential fire support crisis line for fire personnel and their families.
- Law Enforcement Crisis Support Line: 602-433-COPS (2677) – An independent, confidential law enforcement support crisis line for police servicemen and women and their families.