Motor Vehicle License Special Plate Request form
Motor Vehicle License Special Plate Request form
INSTRUCTIONS FOR FILING THE APPLICATION

  1. Complete Sections A & D only.
  2. Attach check payable to "Grand Lodge of Pennsylvania" for $25.00 (Include cost for additional registration cards, if desired.)
  3. DO NOT MAIL IT TO THE BUREAU OF MOTOR VEHICLES.
  4. Mail completed application, and check or money order to:
 
Grand Lodge of Pennsylvania
One North Broad Street
Philadelphia, PA 19107-2598
  1. The Grand Secretary's Office will validate your membership, complete sections B & C, and will forward it to the Bureau of Motor Vehicles.

The State of PA has announced that effective July 17, 2014 specialty plates are now available.

Specialty plates are personalized versions of the Blue Lodge plates above, and cost $125 ($100 plus $25 for the registration).

Specialty plates can be up to 5 characters (alpha or numeric), and may contain one hyphen or space (but not both).

To order the specialty version of the license plate, please fill out this form, enclose $125, and send it to Grand Lodge at the address above.

Any questions call Donna Brett at 215-988-1901 at Masonic Temple Grand Lodge Philadelphia.

PDF files require Adobe Acrobat Reader for Viewing, you can download it for free here.

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