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ASSISTANCE PROGRAMS

100CLUB

Request Forms

Explore Quick links

Line of Duty Death/ON DUTY DEATH/Non-Line of Duty Death - Assistance Request Form

Apply Here

Line of Duty Injury Request Form #1

Please use this form when submitting the initial request for Line of Duty Injury benefits

Apply Here

Line of Duty Injury CONTINUENCE

Please use this form when submitting the initial request for Line of Duty Injury benefits

Apply Here

HELPING EMERGENCY RESPONSE OFFICERS AND SURVIVORS (H.E.R.O.S.)

Heros Request form

Apply Here

Safety Enhancement Stipend

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.

Apply Here

Peer 100 Assistance REquest

Assistance with mental health prevention and intervention services for first responders struggling with the impact of their public safety profession.

Apply Here

Peer 100 Training support

Assist in bringing wellness training to departments across the state. We strive to support group trainings on resiliency, peer support programs, nutrition, financial wellness, family support, sleep deprivation, stress management, mindfulness, suicide prevention, and more.
Apply Here

FINANCIAL ASSISTANCE

PROVIDING ASSISTANCE TO PUBLIC SAFETY HEROES AND THEIR FAMILIES

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 (LODD)
$20,000 one-time assistance
ON DUTY* DEATH (ODD)
$15,000 one-time assistance
NON-LINE OF DUTY DEATH (NLODD)
$10,000 one-time assistance
LINE OF DUTY INJURY* (LODI)
$500 per month based on need
ON DUTY* INJURY
$500 one-time assistance

THE H.E.R.O.S. PROGRAM

HELPING EMERGENCY RESPONSE OFFICERS AND SURVIVORS (H.E.R.O.S.)

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.  When an officer or firefighter is affected by a terminal illness, the loss of a spouse or child, or a tragic life altering event, 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.) program.

SAFETY ENHANCEMENT STIPEND (S.E.S.)

Providing Assistance to Public Safety Heroes and Their Families

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 2022, the Safety Enhancement Stipend program provided $428,530.33 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.
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 our online application portal, linked below.
  • 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.
APPLY

AWARDEE REPORT

  • 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 must be completed online via the link listed below.
2023 ASSISTANCE PROVIDED:

QUARTER 1

$119,839.10

QUARTER 2

$48,270.00

QUARTER 3

$264,554.95

QUARTER 4

$281,321.36

TOTAL

$713,985.41

QUARTERLY APPLICATION DEADLINES:

March 1st, June 1st, September 1st, December 1st

A very special thank you to Valley Toyota Dealers who have generously donated annually in 2018, 2019, 2020, 2021 & 2022 for additional Safety Enhancement Stipends to be awarded in Maricopa County.
A very special thank you to The Bob & Renee Parsons Foundation who have generously donated annually in 2019, 2020, 2021 & 2022 for additional Safety Enhancement Stipends to be awarded across Arizona.

ADDITIONAL RESOURCES

Fire Crisis Support

An independent, confidential fire support crisis line for fire personnel and their families.
(602) 962-9695

Law Enforcement Crisis Support

An independent, confidential law enforcement support crisis line for police servicemen and women and their families.
602-433-COPS (2677)

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