Share or Print this page


Just click on this APPLICATION, fill it out and submit a check for $30 made out to:
Alzheimer's Association
Heart of America Chapter

Send to:
Alzheimer's Association
Heart of America Chapter
3846 W. 75th St.
Prairie Village, KS 66208

Once the 500 commitments are secured, the Alzheimer's Association will send you a certification statement for you to provide to your county treasurer's office when the plates are available. This certification will let them know that you have paid the required $30 royalty fee.

If we do not collect the 500 applications, the fee will be returned to you or you can designate it as a donation to the Alzheimer's Association.

Thank you for your support of this Alzheimer's Awareness License Plate!