FINANCIAL ASSISTANCE REQUEST

Name of First Responder or Military Personnel


When a life-changing event occurs, a representative from the First Responder agency or Military branch will be assigned to support the family and act as a liaison between the agency and those offering assistance during the crisis. If possible, kindly provide the following information:



  • A serious physical injury is a physical injury that creates a substantial risk of death, or causes serious and long-term harm to a person's body. This can include disfigurement, loss of function, or impairment of health. Examples of serious physical injuries include a bullet wound, a serious stab or puncture wound, an amputation, a significant brain injury, paraplegia or quadriplegia and burns to more than 50% of the body.

  • A condition that prevents someone from working for a year or more. It can be caused by a physical injury or mental health issues. Income lost due to an illness or injury that prevents someone from doing their job.

    Eligibility: The condition must be expected to last at least 12 months.

  • A LODD is the death of a First Responder or Military service member while on duty and as a direct result of their job duties. A LODD can be the result of an injury sustained while performing a First Responder’s or Military duties. LODD can occur during an extra-duty assignment, while in uniform, while traveling to or from a duty assignment, the result of taking any reasonable or emergency response action, deaths from traumatic injuries, heart attacks, strokes, or aneurysms. A LODD can include deaths from infectious diseases or illnesses contracted while on duty, Deaths from health issues related to a HAZMAT incident or injuries sustained during physical fitness training as part of a formal training exercise.

  • Aside from the circumstances mentioned above, please let us know how the Arizona Fallen Hero Memorial Riders can assist with your immediate needs. If you are requesting financial assistance, kindly specify the amount needed and explain how the funds will be used.


Requestors Information


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