paper application - Friends of the Smokies

Apply for your Smokies plate today!
Your specialty license plate may be purchased independently of your vehicle’s registration. A Friends of the Smokies
plate is $30 annually in addition to the vehicle registration fee. A plate with personalized letters or numbers is another $30.
For each new or renewed specialty plate, $20 goes toward projects in Great Smoky Mountains National Park. With your
new plate you receive a complimentary one-year membership to Friends of the Smokies. The specialty plate fee is tax
deductible. Additional applications are available at www.friendsofthesmokies.org
Thank you for your support of Great Smoky Mountains National Park.
Friends of the Smokies
828-452-0720
[email protected]
www.friendsofthesmokies.org
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Friends of the Smokies Specialty License Plate Application
Mail completed form with your check payable to: Friends of the Smokies, 160 S Main St, Waynesville, NC 28786
Your vehicle inspection and registration must be current within 90 days of your renewal date for your application to be processed.
Select One:
$30 Regular Friends of the Smokies Specialty License Plate
$60 Personalized Friends of the Smokies Specialty License Plate
Please Print
Name – (First, Middle, Last) ________________________________________________________________________
Name as shown on Certificate of Title (if different) – (First, Middle, Last) ___________________________________
Address _________________________________________________________________________________________
City ______________________________________________
State
NC
ZIP _______________________
Phone _________________________________ Email ___________________________________________________
(We look forward to keeping in touch with you)
Drivers License # ____________________________ Current North Carolina Plate Number: ___________________
Vehicle Identification Number (VIN) ________________________________________________________________
Year _________ Make ___________________ Model ________________ Body Style _______________________
Expiration Date of Current Vehicle Registration _____________________
Owner’s Certification of Liability Insurance
I certify for the motor vehicle described above that I have financial responsibility as required by law.
Print full name of insurance company authorized in N.C. (not an agency or group)
______________________________________________________________________
Policy Number - if policy not issued, include name of agency binding coverage ______________________________
Signature of Owner _____________________________________________________ Date ____________________
Print and Sign
Personalized Plates ($60) - You are allowed four (4) spaces:
*Personalization cannot be all numbers
1st choice
S
__ __ __ __ M
2nd choice
S
__ __ __ __ M