You can obtain the correct PennDOT form from:
1) Your Temple Recorder -OR-
2) Download and complete the PDF Application form
a. Click here to download the PDF Application Form
b. Complete Section A of the application
c. Sign the application in Section D only.
DO NOT sign in Section C.
d. Make check for $28.00 payable to:
Commonwealth of Pennsylvania
e. Mail the check and application to the address
in Section B
For information, Rajah Shriners contact Noble Joseph Hagan at 610-916-9000 or Click Here to email us.
This is program is available to all Pennsylvania Shriners!
Your license plate will look just like the one shown above. (Without the SAMPLE stamped on it!)