Award Nomination Payment Please use the form below to pay the fees for your 2019 Awards Nominations. Name* First Last Email*This needs to be the email address that was used to submit the award. Phone*Award Fee*Nominee is a USDLA Member: $100.00Nominee is not a USDLA Member: $200.00$200.00 fee for non-USDLA members includes one USDLA individual membership.Number of Awards*If you need to pay for more than one award, please indicate here.123456789Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Credit card processing by Stripe. No credit card information is stored on USDLA servers.
