Type of Request* First Year Win: 2017 (Complimentary) Reneweal ($300 fee) Name of Winning Product(s) and year of win:*Example: Musical Owl by ALEX, 2013Company/manufacturer/publisher/PR firm:*Name* First Last Email* Phone*Renewal Fee Price: $300.00 Payment Method*PayPalCheckCredit card users please note: The charge on your statement may show up as "NAPPA," "L.A. Parent" or "Epstein Custom Media."Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name When paying by check, we will email your e-seal once payment is received. Make checks payable to NAPPA and send to: NAPPA 5855 Topanga Canyon Blvd., Suite 210 Woodland Hills, CA 91367* By checking here, I accept the terms of the NAPPA License Agreement Form. I understand that NAPPA seal artwork may only be reproduced with prior NAPPA approval. This request will not be processed without checking this box. This iframe contains the logic required to handle Ajax powered Gravity Forms.