Hoops Family Children’s Hospital License Plate

For the first time ever, supporters of the Hoops Family Children’s Hospital can tell the world about their support of quality children’s medical treatment with a specially branded West Virginia license plate. The cost per plate is $91.50.

Please fill out the form below to get started.

Don’t want to order online? See mailing instructions below.

Name of Applicant(Required)

Telephone Number(Required)

Name(s)(Required)

Name(s) of owner(s) exactly as shown on current registration for vehicle you wish to register.

Present Street Address(Required)

City(Required)

State(Required)

Zip(Required)

Current License Plate Number(Required)

Title Number(Required)

Model Year(Required)

Make(Required)

Vehicle Identification Number(Required)

NAIC(Required)

Name of Insurance Company(Required)

Policy Number(Required)

Agent(Required)

Signature(Required)

How would you like to pay?(Required)

Pay Online

Pay Offline by Check

Payroll Deduct

Hoops License Plate

Total

If paying $91.50 by check, please mail the the check to: FOUNDATION @ 1340 Hal Greer Blvd, Huntington WV 25701. Please put LICENSE PLATE in the note of the check.

Employer

Employee Number

$91.50 will be deducted

Credit Card

Card Details

Cardholder Name

License Plate Application Guidelines

The vehicle on which the plate will be placed must be a Class A (passenger car or truck 10,000 lbs or less) and currently titled in West Virginia. Leased vehicles are eligible for this plate.

There are no restrictions on the number of special license plates you may obtain.

Cost and Expiration Details

The cost per plate is $91.50. This will cover the cost of the license plate for the first year or portion of the first year. These plates will expire July 1 of each year. This is a flat fee for all applicants and is not prorated. This initial application process is only to determine whether your organization has the minimum level of interest to pursue the design and manufacturing of the new license plate. Please continue to renew your present license plate during this process.

Your renewal will be processed by DMV. Your organization is not involved in the renewal process. The renewal fee will be $66.50 per year.

Application Submission Deadline

Please Call Bradley Burck at (304) 526-2658 if you have any questions.

Mailing Instructions

Click here to download an application.
Please mail your completed application and payment to:

Hoops Family Children's Hospital
Attention: Bradley Burck
1340 Hal Greer Blvd.
Huntington, WV 25701

Do NOT make your check payable to DMV.

Do NOT mail or bring your application to the division of motor vehicles.

Instructions(Required)

I have ready and understood the above instructions

Hoops Family Children’s Hospital License Plate

Please fill out the form below to get started.

License Plate Application Guidelines

Cost and Expiration Details

Application Submission Deadline

Mailing Instructions

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