Choose Life Delaware, Inc.

Supporter Application

Choose Life Delaware, Inc. is a non-profit, all volunteer organization with a required annual supporter fee of $20. These fees are distributed to agencies in Delaware that promote adoption instead of abortion.

As a supporter of Choose Life DE, Inc. a State of Delaware organization auto license plate is available to you for a one time fee of $10 to the state, plus the $20 annual supporter fee.

The initial 200 applications requirement of the State of Delaware to manufacture/issue the Choose Life organizational license plate was submitted in June. The first plates were on the road in August 2010!

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Instructions

  1. To join Choose Life Delaware, Inc. complete the form below.

2.  To apply for a Choose Life, State of Delaware license plate, complete the Application for Specialty License Plates - DMV form 613.

3.  Make a check payable to “Choose Life Delaware, Inc” for the amount of $30.

  1. The $30 includes the $20 Choose Life Delaware, Inc. supporter fee and the one time $10 DMV fee for the Choose Life organization license plate.
  2. A supporter may apply for more than one license plate.

·  Complete one “Application for Specialty License Plates” form for each vehicle.

·  Include $10 for each license plate request.

  1. Please DO NOT make checks payable to the State of Delaware or the DMV. Choose Life Delaware, Inc. will present one check for the total amount of all the initial 200 applications for the Choose Life license plate.
  2. Return your completed applications and check to the supporter campaign volunteer.

8.  Attach a copy of your DE Vehicle Registration Card to the “Application for Specialty License Plates." Accuracy and legibility of all information on the State of Delaware application form is VERY IMPORTANT!

  1. License plates number 7 thru 200 will be assigned by lottery, thereafter consecutively on a first come first served basis.

10.  If mailing, mail forms to "Choose Life Delaware, Inc., 129 Brandywine Dr., Dover, DE 19904.

Choose Life Delaware, Inc. Application

First Name
Middle Initial
Last Name
Street Address
City, State, Zip
Phone Number
Email Address
Signature / Date