Www.dot.state.wy.us

[Pages:1]STEP #1

STEP #2

APPLICATION FOR UNIVERSITY OF WYOMING PLATES

APPLICANT AND VEHICLE INFORMATION

Applicant Name (Must be an owner or lessee on the vehicle title)*

Mailing Address

City

State

ZIP

Daytime Phone Number

() -

Vehicle Make

Year

Email Address Model

VEHICLE TYPE

County Where Vehicle Will Be Registered

Passenger Car, Truck, or SUV

Motorcycle

*Applicant is not required to be an alumnus of the University of Wyoming to apply for UW plates

OPTIONAL - EMBOSSED (Additional fee of $50.00)

I would like my plate embossed for an additional fee of $50.00

Embossed plates have raised numbers that are stamped into the plate as opposed to the flat printing of standard

plates. These plates may take an additional 10-12 weeks for processing.

Completed application shall be mailed to the address shown at the bottom of this form, along with a fee of $130.00 made payable to the University of Wyoming ($100 fee for UW scholarships or student programs and $30 special plate fee). The application will be reviewed by the University and, if approved, forwarded to the Wyoming Department of Transportation. Plates will be issued numerically in consecutive order and forwarded to the County Treasurer's Office of the county numbered on the plate. Applicant is responsible for making arrangements with the county for pickup/delivery of plates. Current plates must be surrendered to the Treasurer's office upon issuance of the UW plates. UW plates cannot be personalized.

AFFIDAVIT

I hereby swear or affirm under penalty of perjury that all information on this application is true and correct.

Signature of Applicant

Date

STEP #3

STEP #4

APPLICANT SHALL MAIL THIS APPLICATION AND FEE PAYABLE TO THE UNIVERSITY OF WYOMING: University of Wyoming, Alumni Association Marian H. Rochelle Gateway Center 222 S. 22nd St Laramie, WY 82070 Please allow 4-6 weeks for processing.

STEP #5

FOR ADDITIONAL INFORMATION PLEASE CALL: 307-777-4709 (WYDOT) or 307-766-4166 (UWAA) or visit our website at

FOR UNIVERSITY OF WYOMING USE ONLY

Plate #

Approved By

Date

FOR WYOMING DEPARTMENT OF TRANSPORTATION USE ONLY

Issued By

Date

MV-143 (10/16)

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