Request for Assistance

Please use this online form as a request for assistance from Backing the Blue Line. We will review the request and respond according to our Standard Operating Procedures. If this is urgent please feel free to contact us at, this email is monitored closely.

If you have questions, please contact Family Support Chair Jeni at

Requester's Information
Your Name *
Your Name
Person In Need's Information
Name *
Family or Department Contact
Family/Dept Contact Name
Family/Dept Contact Name
Request Information
What is the request for? Roses at a funeral, an illness/injury care package, or other services requested? Please give us as much information as possible to help decrease the need to investigate before we can act. Dates, hospital location, how long they will be there, any other information that may be helpful for us to fulfill your request, ect. THANK YOU!
Is this public or confidential information? *
Do you want a response from BtBL? *

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Backing the Blue Line: Police Wives of Minnesota
6066 Shingle Creek Pkwy #344
Brooklyn Center, MN 55430

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