Special License Plate Series Signature
Before the Department of Licensing (DOL) considers the Donate Life Washington plate series, we require at least 3,500 intended license plate purchases. Signing this form indicates your intent to purchase these plates, if they become available. Proceeds from the special license plate sales will fund public education and outreach about organ donation in communities all across Washington.
Contact Email (This will be used for confirmation only. LifeCenter Northwest will contact you when legislation is passed and the license plate is available for purchase.)
example@example.com
Intended number of plates:
Name
First Name
Last Name
Signature
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Should be Empty: