APPLICATION FOR A ROCKY MOUNTAIN ELK FOUNDATION LICENSE PLATE
PLEASE NOTE: When applying for a Personalized Rocky Mountain Elk Foundation license plate, the letter suffix
representing the attraction must be the last letter on the plate. This only leaves four (4) spaces for a personalized
message. The four spaces may be a combination of letters or numbers but cannot conflict with another classification
of license.
 Regular Rocky Mountain Elk Foundation $ 25.00
 Personalized Rocky Mountain Elk Foundation $ 45.00
NOTE: You are allowed four (4) spaces for a personalized message.
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The $25.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
NAME (To agree with certificate of title)
Home
FIRST
Area Code-Telephone Number
Area Code-Telephone Number
LAST
ADDRESS
CITY
Office
MIDDLE
STATE
ZIP CODE
Current North Carolina
______________________
Plate Number
______________________
Driver License #
__________________________________
Vehicle Identification Number
__________________________________
Year Model Make Body Style
Owner's Certification of Liability Insurance
I CERTIFY FOR THE MOTOR VEHICLE DESCRIBED ABOVE THAT I HAVE FINANCIAL
RESPONSIBILITY AS REQUIRED BY LAW.
_________________________________________________________________________________________
PRINT OR TYPE FULL NAME OF INSURANCE CO AUTHORIZED IN N.C. –NOT AGENCY OR GROUP
______________________________________________________________________________
POLICY NUMBER – IF POLICY NOT ISSUED, NAME OF AGENCY BINDING COVERAGE
__________________________________
SIGNATURE OF OWNER
_________________________
DATE OF CERTIFICATION
To Order:
Make checks payable to RMEF and return to:
Tim Queen RMEF State Chair
70 Weaverville Hwy, Asheville, NC 28804
Mail or Call: 828-255-0956
Or.
Credit Card no. ______________________________
Expiration Date______________________________
Cardholder Name ____________________________
Signature ___________________________________