Application of Gift

This is an application to receive aid or relief, monetarily or otherwise, created by Vigilant Watch. This charitable relief will provide support to our Regional first responder public safety officials (Police, Fire, Sheriff’s Dept., and EMS), active, retired and their immediate families, (herein called PSO), without regard to Race, Color, Creed, Religious affiliation, familiar status, handicap, or sexual orientation, whether in the line of duty or not, who have suffered a hardship based on an injury, illness, or catastrophic event which has created a financial or physical hardship.

Currently, applications for aid or relief from residents of the Hampton Roads and Eastern Shore of Virginia areas are being accepted.

Vigilant Watch, Inc. has a non-profit status under Section 501 (c)(3) of the Internal Revenue Code. This application must be completed in accordance with the instructions to the Vigilant Watch Application of Gift instructions. The full list of instructions can be viewed here.

All fields listed with an * are required.

Relationship of Applicant to PSO :

Status of PSO with department :

Add New Dependent
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Add New Dependent
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Add New Dependent
Remove Next Dependent

Verification of Medical Condition or Catastrophic Event :

Is money needed?

Would volunteer help benefit you?