Award Nomination Payment Please use the form below to pay the fees for your 2021 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 ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Credit card processing by Stripe. No credit card information is stored on USDLA servers.
