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The Larry Pickett Foundation

a 501(c)(3) nonprofit organization

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Apply for a Stabilization Grant

Apply for a First Responder Equipment Grant

Department & Government Authority

Chief’s Name
Primary Station Address

Governmental Funding Substantiation

Please list the city, county, or municipal body that holds ultimate budgetary authority for your department.
Is this equipment a recognized public safety requirement?
Explain why the local municipality or government body is currently unable to provide funding for this specific request.
How will this equipment specifically 'lessen the burden' on local taxpayers or emergency services?

Equipment Specifications & Procurement

Include Make/Model if known
Drag & Drop Files, Choose Files to Upload
Does your requested equipment meets or exceeds current NFPA and OSHA safety standards.

Narrative Advocacy

Describe how this equipment will help change the outcomes for your crew and or citizens
Estimated population served and square mileage of your district
Media & Content Authorization

Legal Certifications & 85/15 Agreement

I certify that no member of this department's leadership is a relative or business associate of the Larry Pickett Foundation Board
The 85/15 Impact Agreement
Governmental Intent Statement
Agree to receive text messages