AKA Special Interest Plate

AKA Special Interest Plate

Membership Verification Form
This opportunity is brought to you by the New Haven Pearls of Excellence Foundation, a 501(c)(3) organization.

Procedure
1. Complete this Membership Verification Form to apply for the AKA Special Interest Plate issued by the Connecticut DMV. This form will be used to verify membership and has a $25.00 processing fee paid to the New Haven Pearls of Excellence Foundation.
2. Complete the Special Interest Plate Application (CT DMV Form M-37).
3. Obtain a check or money order payable to "DMV" for the plate you are requesting found on the DMV application.
4. Mail your completed DMV application and check or money order to New Haven Pearls of Excellence Foundation, P.O. Box 3665, Woodbridge, CT 06525.
Deadline for submission has been extended! Please submit your application as soon as possible to be included in the initial order to the CT DMV.

Contact Us

E-mail info@nhpoefoundation.org or Call/Text (203) 747-8963

Visit our website for FAQs and other information at www.nhpoefoundation.org.
Contact Information
Full Name*

First NameMiddle NameLast Name
E-mail*
example@example.com
Phone Number*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Member Details

This information will be used to verify your membership in Alpha Kappa Alpha Sorority, Incorporated®.
Current Membership Status*
Initiation Date*

MonthDayYear
Date
Chapter of Initiation*
Current Chapter*
Type your current Chapter Name. If you are not affiliated with a chapter, type whichever is applicable: Inactive, General Member, or Life Member.
Name at Initiation*

First NameMiddle NameLast Name
DMV Special Interest Plate
Current Plate Info*

Current Plate No.MakeModel
Plate Selection*

Transfer my vanity, low number, or current marker plate to the AKA backgroundReplace my current marker plate with an "off-the-shelf" plate on the AKA backgroundI do not have a vanity plate but wish to obtain one on the AKA background
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
My Products
prevnext( X )
Special Interest Plate Processing FeeProcessing fee will be refunded if the minimum order of 400 plates is not met.
$25.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

AKA Special Interest Plate

Contact Information

Member Details

DMV Special Interest Plate