JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
BSA Virginia License Plate Request
This form is used to register interest in obtaining a BSA license plate from the Virginia DMV. A total of 450 interested parties are required in order for the DMV to create the plate. You must have a vehicle with Virginia plates in order to register interest. Once enough responses are obtained, you will be asked to pre-pay for the new license plate.
Registering here is making a preliminary commitment to purchase a BSA license plate for a vehicle registered in the State of Virginia.
For further information, please see our
FAQ's
Sign in to Google
to save your progress.
Learn more
* Indicates required question
This is the concept for the new License Plate
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
How many license plates do you wish to order?
*
1
2
3
4
5
6
7
8
9
10
Is it ok to contact you for more information?
*
yes
no
Required
Do you have any suggestions on the design of the license plate?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms