Minnesota 100 Club | Benefits / Financial Resources

Offering Financial Resources to Those in Need

The Minnesota 100 Club pays a death benefit of up to $50,000 to families of Minnesota’s city, state, and federal public safety officers, firefighters, EMS/EMTs and correctional officers who are seriously injured or killed in the line of duty. Benefits to those who have been critically injured vary and will be determined by the MN 100 Club Board of Directors.

The Minnesota 100 Club is proud to partner with Washburn-McReavy Funeral Chapels to help aid families in need. Washburn-McReavy is committed to providing discounted Professional Services to qualifying families. To learn more and find out if you qualify, please contact Washburn McReavy directly.

Contact Washburn McReavy

Assistance for Catastrophic Injuries

First Responders and Correction Officers who are catastrophically injured in the line of duty and have been unable to work for a minimum of 30 days may apply for financial assistance which will be reviewed by the Benefits Committee on a case by case basis.

Apply for MN 100 Club Benefits

Application for MN 100 Club Benefits

Officer/Firefighter/EMT-EMS/Corrections Officer

DEATH OR SERIOUS INJURY REQUEST FORM

Information Provided By Name:*
Title / Relationship*
Mobile Phone*
Office Phone
Home Phone
Email*
Department / Agency (if applicable)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of Injured or Deceased*
First Last
Birth Date*
MM slash DD slash YYYY
Date of Injury/Death*
MM slash DD slash YYYY
Line of Duty?
- Yes
- No
Please describe the event leading to the First Responder's injury or death
Please attach supporting documentation if possible
Drop files here or

Max. file size: 32 MB.
Years of Service
Please enter a number less than or equal to 100.
Title/Position
Employed with what level of government or oganization?
Spouse Name (if applicable)
First Last
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
Work / Other Phone
Email
Make Benefit Check to
Dependents (other than spouse) & Birth Dates
CAPTCHA

If you would rather print and mail in application please download the form below and send to:

Minnesota 100 Club
P.O. Box 1066
Anoka, MN 55303

If there are any questions we can answer for you –or- you need any assistance filling out this form, please feel free to call Minnesota 100 Club executive director Julie Gotham at 952-500-2189

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