Scholarships

Section A

School Year you are enrolling*

College/School to which you are applying*

Semester you are enrolling*

Fall
Spring
Summer

Section B

Have you previously received a scholarship from the Smeltzer Trust?*

Yes
No

If yes, which year?

Are you applying for other scholarships?

Yes
No

If yes, from whom and for what amount?

Section C

Legal Name*

First Last

Gender*

Female
Male

Birthdate*

Phone*

Address*

Street Address City State ZIP Code

Email*

Proposed College Major*

The scholarship includes areas of study listed below. Please check the area in which you are insterested.*

Art
Music
History
Environmental Stewardship and Conservation

State your plans for your future.*

List school, church and community activities in which you have participated (list offices and leadership roles you have held)*

Section D (To be completed by first time freshmen only)

High School Name

Address

City State ZIP Code

High School Academic Verification must be completed by high school counselor or principal.

Please mail a copy to:
Ann Smeltzer Charitable Trust
c/o Scholarship Applications
PO Box 791
Fort Dodge, Iowa 50501-4245

Number of Students in Class

Class Rank

Current Cumulative GPA in hundredths (A=4.00, B=3.00, C=2.00, D=1.00)

Section E (Returning and Transferring students only)

Please attach a copy of your current college and high school transcripts.

An official transcript must be sent directly to:
Ann Smeltzer Charitable Trust
c/o Scholarship Applications
PO Box 791
Fort Dodge, Iowa 50501-4245

Section A

Section B

Section C

Section D (To be completed by first time freshmen only)

Section E (Returning and Transferring students only)

Upcoming Events