Educational / Outreach Application

The Ann Smeltzer Charitable Trust grants funds to programs that are specific, non-recurring, broadly based projects in Webster County, Iowa that will benefit a cross-section of our community. The Trust funds are used exclusively for those things that meet our Mission Statement guidelines.

Please submit the following information in the online form AND send a copy to the Grants Committee no later than six months prior to the event.

Ann Smeltzer Charitable Trust
c/o Grants Committee
P.O. Box 791
Fort Dodge, Iowa 50501

Organization Name*
Are you a 501(c)(3) tax-exempt organization?*
- Yes
- No
If so, please attached a copy showing exemption. A hard copy also needs to be sent to:
Ann Smeltzer Charitable Trust
c/o Grants Committee
P.O. Box 791
Fort Dodge, Iowa 50501
Exemption Document
Max. file size: 2 MB.
Contact Person*
First Last
Position*
Address*
Street Address City State ZIP Code
Phone Number*
Fax Number
Email*
Name of Project or Event*
Date of Event or Project Beginning*
MM slash DD slash YYYY
Today's Date*
MM slash DD slash YYYY
Amount of Request ($)*
Budget for Event ($)*
Attach file to supplement request or budget (optional)
Max. file size: 2 MB.
Make check payable to*
Forward check to*
Street Address City State ZIP Code
Please answer the following questions as directly and succinctly as possible.
Explain how funds requested will be used.*
Explain the purpose of this event.*
Identify the population sector that will benefit from this event.*
Describe any other financial support available for this event.*
Is this event promoted or sponsored by a coalition or collaboration? If so, please describe.*
Evaluation of event: Please attach a separate sheet and any related materials (brochures, flyers, etc.) explaining this event.
Max. file size: 2 MB.
*If the Event does not take place as scheduled, or the grant amount exceeds your expenses for such event, the funds must be returned to the Ann Smeltzer Charitable Trust.
Upload additional file (optional)
Max. file size: 2 MB.
Upload additional file (optional)
Max. file size: 2 MB.
Upload additional file (optional)
Max. file size: 2 MB.

Please answer the following questions as directly and succinctly as possible.