DCPWCC 2026 Blue & Silver Scholarship Application

Top Ladies of Distinction, Inc. (TLOD) Dale City - Prince William County Blue & Silver Community Service Trunk Scholarship Application

Application Deadline: April 12 2026 at 11:59 pm EST Incomplete or application received after the deadline will not be considered. *No exceptions.
Thank you for taking time to apply for a TLOD Dale City - Prince William County Chapter Blue & Silver Community Trunk scholarship with a value of over $320.00 for 2025-2026 program year to be used for 2026-2027 academic year. To apply for the scholarship, please complete this application in full. The application, including all supporting documents must be completed and filed by the deadline for review by the TLOD Dale City - Prince William County Chapter Scholarship Committee. The Scholarship Committee will not consider an incomplete or late application, no exceptions.
Must Read the 2026 DCPWCC Blue & Silver Community Service Trunk Scholarship Criteria.

Anticipated Institution of Higher Learning

Please fill out the below information.
Plan to attend (select one)*

CollegeUniversityUndecided
Name of College/University
College Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University Entrance Date

MonthDayYear
Date
Acceptance letter from college/university :

Upload copy of letter of acceptance from college/university
Copy will be required prior to receipt of trunk if selected as a recipient Cancelof
Will you live on campus?*
Proof of on campus paid housing deposit:

Upload Copy of proof of on-campus paid housing deposit
Copy will be required prior to receipt of trunk if selected as a recipient Cancelof

How Did You Hear About The Trunk Scholarship?

Select all that apply
How did you hear about the trunk scholarship?*

Top Lady of Distinction MemberTop Teen of America MemberHigh SchoolCommunity EventChurch AnnouncementSocial MediaOther

3. Honors/Awards

Pleas be specific and upload additional file as needed.
List your honors/awards (include descriptions or details as attachments):*
Honors/Awards
Additional honors/awards details can be uploaded here (optional):

Upload honors/awards descriptions or details

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4. Extracurricular Activities

Please follow the below instructions.
List your extracurricular activities (include descriptions or details as attachments):*
Extracurricular Activities
Additional extracurricular details can be uploaded here (optional):

Upload extracurriculars descriptions or details

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5. Community Service Activities

Must have completed a minimum of 30 hours of community service.
List your community service activities (include descriptions or details as attachments):*
Community Service Activities
Proof of community service hours:

Upload proof of community service hours completed

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Additional community service details can be uploaded here (optional):

Upload community service descriptions or details

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6. Letter of Recommendation

Letter must be on letterhead, dated and signed
Community Leader Name*

First NameLast Name
Community Leader Title*
Upload Community Leader reference letter here:*

Community Leader Recommendation Letter
Letter must be dated and signed. Cancelof

7. Transcripts

Please follow the below instructions.
Include transcripts from Accredited school through the 1st semester of the Senior Year. Transcript should reflect that all graduation requirements have been met, (to include documentation of dual enrollment, along with grades). An example of dual enrollment would be taking courses at Northern Virginia Community College while in High School.
Submit transcripts here:*

Upload transcripts

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9. Photograph

Please upload or take a photo of yourself.
Submit a photo to be used in the event you are selected as a trunk scholarship winner.
Submit photo here or take photo below:

Upload photo

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Take Photo or submit photo above:

10. Assignment of Rights & Consent to Publish Scholarship Information

Please follow instructions below.
Download and complete the Assignment of Rights & Consent to Publish Scholarship Information. Upload completed form below. Sign using the draw tool or print and sign.
Submit signed copy of Assignment of Rights & Consent to Publish Scholarship Sign using the draw tool or print form and sign. Information Form here:*

Upload Consent Form

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11. Signatures

Please download, complete, sign and date the Signature Acknowlegement Form. Upload form below. Sign using the draw tool or print and sign.
Download and complete the Signature Acknowledgement Form. Upload completed form below.
Upload Signature Acknowledgement Form here: Sign form using the draw tool or print form and sign*

Upload Signature Acknowledgement Form

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1. Basic information