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Jackson State University Specialty Plates  
Sign-up to make JSU specialty license plates a reality in North Carolina. Help us reach the required 500 sign-ups in order to make Jackson State tags available in our state! Simply complete the form below to show your support. When you're done, be sure to share it with other North Carolina Jacksonians.

(Please complete the form only if you are a resident of the State of North Carolina)
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First Name
Middle Initial
Last Name
Email Address
Is the email address listed the same as your online payment email (CashApp / PayPal)? If not, please list your online payment email.
Graduation Year
JSU Affiliation
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City
Mailing Address
Zip Code (Only North Carolina Residents Please)
Phone Number
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