APPLICATION FOR UNIVERSITY OF WYOMING PLATES
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APPLICANTAND VEHICLE INFORMATION
Applicant Name (Must be an owner or Jessee on the vehicle title}*
Mailing Address
City
IState
IZIP
Daytime Phone Number
( )
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Email Address
Vehicle Make
IYear
Model
VEHICLE TYPE
D Passenger Car, Truck, or SUV D Motorcycle
County Where Vehicle Will Be Registered
*Applicant is not required to be an alumnus of the University of Wyoming to apply for UW plates
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OPTIONAL- EMBOSSED(Additional fee of $50.00)
LJ 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.
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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.
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AFFIDAVIT
I hereby swear or affirm under penalty of perjury that all information on this application is true and correct.
Signature of Applicant Date .
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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. 22
nd
St
Laramie, WY 82070
Please allow 4-6 weeks for processing.
FOR ADDITIONAL INFORMATION PLEASE CALL:
307-777-4709 (WYDOT) or 307-766-4166 (UWAA)
or visit our website at htt R:lLwww.dot.state.w ~.us
FOR UNIVERSITY OF WYOMING USE ONLY
Plate#
Approved By
Date
FOR WYOMING DEPARTMENT OF TRANSPORTATION USE ONLY
Issued By Date
MV-143 (10/16)
