PA Breast Cancer Coalition Breast Cancer Awareness License Plate

TO ORDER YOUR PLATE*:Please complete the information below AND the attached PennDOT form. Return both forms with your payment to:

PA Breast Cancer Coalition, 2397 Quentin Road, Suite B, Lebanon, PA 17042.

IF YOU LEASE YOUR CAR: Please note, you will need to fill out an additional form that gives you ownership of the license plate. This form is available at http://pbcc.me/Plate or by calling 800-377-8828 x2308.

*The PBCC must process your application then forward it to PennDOT. PennDOT will not accept any applications that come directly from individuals. No refunds can be made after your plate order is placed.

Be a Driving Force in the Fight Against Breast Cancer!

Name:

Address: City: , PA ZIP:

Email: Phone:

Total Amount Remitted: $ (Please add an additional $2.00 for each EXTRA registration card requested.)

Payment Method:

Check Enclosed (Check #: ) Please make check payable to “PA Breast Cancer Coalition.”

Credit Card Number: Expiration: CVC:

Visa Mastercard Discover American Express Signature:

$50(for regular plate)

New- Personalized Breast Cancer License Plates for $200!

Breast Cancer License Plate Frequently Asked Questions

Have a question not answered here? Call 800-377-8828 x2308

When will I receive my plate? How long does the license plate application process take? The PA Breast Cancer Coalition sends applications to PennDOT twice a month. Once PennDOT receives the applications they make the license plates. The plate will arrive in your mailbox approximately 6-8 weeks from when PennDOT receives your application.

How do I order extra registration cards?You will receive one registration card automatically with your purchase of an awareness plate. If you wish to have extra copies, please indicate how many EXTRA cards you would like at the end of Section A on the PennDOT application and add $2.00 for each extra card ordered. If you want only one registration card, please leave this line blank.

My registration is due soon (or I just renewed my registration). What should I do?Please do not let your registration lapse. Purchasing the breast cancer awareness plate does not automatically renew your registration. The one time fee covers the cost of the new plate, not the annual registration fee.

If your registration expires within the next few months, we recommend you renew your registration first. Once your new sticker arrives, put it on your current plate. At that point, you may apply for the breast cancer awareness plate. When your new plate arrives, it will come with a new sticker and registration card. This ensures that PennDOT is not processing both your registration renewal AND application for a new plate at the same time.

Can I order the breast cancer awareness plate as a gift for someone?You may pay the fee for someone else’s specialty plate, but a registered owner of the vehicle needs to sign the application.

Can I choose my own numbers or personalize the license plate?Yes, an additional $150 fee ($100 PennDot fee + $50 PBCC fee) is required. The total cost of a personalized PBCC breast cancer license plate is $200.

I have a Person with Disability license plate. Can I get the breast cancer awareness plate with this logo?PennDOT will not offer any specialty plate with the Person with Disability insignia. A customer can apply for the breast cancer awareness plate and apply for a Person with Disability placard, which hangs on the rear view mirror. This will afford you the same parking privileges as a Person with Disability plate while still supporting the PA Breast Cancer Coalition. If you wish to apply for the placard, visit the PennDOT website (www.dmv.state.pa.us) and download form MV-145A.

Do I need to be a member of the PBCC to order this plate?The General Information section of the PennDOT application mentions being a member of the organization. This is standard PennDOT language which we are not permitted to revise. The PA Breast Cancer Coalition does not have memberships. Anyone living in Pennsylvania can order the breast cancer awareness license plate, as long as your vehicle meets the other requirements listed on the PennDOT application.

17042

PA Breast Cancer Coalition

2397 Quentin Road, Suite B Lebanon PA

Michelle Goodreau Database Manager

17042

$150 The total cost for a personalized plate is $200.)

25 50PA Breast Cancer Coalition

$150 $150