Donation Application Form

Thank you for your interest in a donation from the Christina Rose Smith Foundation: Making Moments Matter. Please complete the following form. All applications that meet the stated criteria will be reviewed, but meeting the eligibility criteria does not guarantee a donation due to limited resources. Applicants are encouraged to provide as much detail as possible to help with informed decisions.

Submission Deadlines

We accept applications on a rolling basis, but to be considered for the current donation cycle, applications must be received by: November 1, 2025.

Please complete the form below and furnish all supporting documents, email crsmakingmomentsmatter@gmail.com, or mail to:

The Christina Rose Smith Foundation: Making Moments Matter
510 South Lodge LaneLombard, IL 60148

Eligibility Checklist

To qualify, your organization must meet the following criteria:
– Required: U.S.-based 501(c)(3) non-profit organization
– Required: Request aligns with one or more of our charitable focus areas:
– Scholarship and Education
– Community Outreach
– Youth Safety and Awareness
– Other Community Needs
– Preferred: Your project serves one of our priority regions:
    – Chicagoland
    – SW Michigan
    – Greater Minneapolis, MN
    – Tucson, AZ

We do not fund:
– Individuals
– Political campaigns or lobbying efforts
– Organizations without IRS 501(c)(3) status
– Projects not aligned with our mission

Legal Organization Name *

Contact First Name *

Contact Last Name *

Title *

Email *

Phone Number *

Tax ID (EIN): *

Organization Website

Mailing Address *

City *

State *

Zip Code *

IRS 501(c)(3) Determination Letter *

Amount Requested (USD): $ *

Brief Summary of Request (3–4 sentences): *

I certify that my organization meets the eligibility criteria stated above.