Entry Fee Payment Form

MEMBERS & NON-PROFIT ORGANIZATIONS
EARLY ENTRY FEE (Due date: March 28, 2018)
 

CONTACT INFORMATION:

Submitter Name:
Company:
Email:
Phone:

ENTRY FORM INFORMATION:

Campaign Name:
Category:
 Best 360º Campaign
 Best Social Media Campaign
 Best Social Responsibility Campaign
 Best Online Promotion
 Best Mobile Execution
 Best Web UI & UX
 Best Video Execution
 Best use of Content Marketing
 Best use of Data Driven Solutions or Campaigns
 Best Campaign for International Market

Entry Fee
SME Members & Non-Profit Organizations | 1 category per case or campaign: $100

  • Fees may be paid by credit card or check.
  • If an entry is submitted to multiple categories, fees are payable for each category in which an entry is submitted.
  • If the payment method is going to be check, it must be received before March 14

PAYMENT INFORMATION:

Total Payment:
Payment Method:
Card Type:
Name on card:
Credit Card Number
Expiration Date
4 digits in front of card- required for AMEX

NUESTROS PATROCINADORES


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