North Carolina Division of Motor Vehicles
Application for Collegiate Insignia License Plate
(MVR-27C)

Remit a $25.00/$55.00 check or money order with this application.

College Name

Select one of the following:

First in Flight Background

First in Freedom Background

Select one of the following:

Regular Collegiate $25.00

Personalized Collegiate $55.00

NOTE: You are allowed four (4) spaces for a personalized message.

When applying for a Personalized Collegiate license plate, the prefix/suffix will be the first/last letters on the plate. This leaves only four (4) spaces for a Personalized message. The four spaces may be a combination of letters and numbers, but cannot be numbers only. Choice cannot conflict with another class of license plates.

The $25.00/$55.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.

Owner Information

Name (To agree with certificate of title)

First

Middle

Last

Email

Home Area Code - Telephone Number

Office Area Code - Telephone Number

Address

City

State Value is not selected

Zip Code

Vehicle Information

Current North Carolina Plate Number

Current North Carolina Driver License #

Vehicle Identification Number

Year

Make

Model

Body Style

Owner’s Certification of Liability Insurance

I certify for the motor vehicle described above that I have financial responsibility as required by law.

Print or Type Full Name of Insurance Company Authorized in N.C. - Not Agency or Group

Policy Number - If Policy not issued, name of Agency Binding Coverage

Signature of Owner

Date of Certification

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5/28/24 MVR-27C Application for a Collegiate Insignia License Plate

Owner Information

Vehicle Information

Owner’s Certification of Liability Insurance