Emmy
®
Awards
2023 Emmy
®
Awards Call For Entries
Emmy
®
Awards Archive
2021 Winners
2021 Nominees
2020 Emmy
®
Awards
2020 Winners
2020 Nominees
Awards Store
Membership
Become A Member
Sign in to Emmy
®
Express
Gold & Silver Circles
Gold & Silver Circle Honorees
2022 Silver Circle Inductees
2021 Silver Circle Inductees
Nomination Form
Education
2023 Student Awards Call For Entries
2023 STUDENT AWARDS:
ENTER HERE
Scholarship Information
Student Awards Archives
2022 Student Award Nominees & Winners
2021 Student Award Nominees & Winners
Continuing Education Grant for Professionals
About
Contact Us
Mid-America Emmy
®
Region
Board of Governors
NATAS Mid-America Foundation
Emmy
®
Awards
2023 Emmy
®
Awards Call For Entries
Emmy
®
Awards Archive
2021 Winners
2021 Nominees
2020 Emmy
®
Awards
2020 Winners
2020 Nominees
Awards Store
Membership
Become A Member
Sign in to Emmy
®
Express
Gold & Silver Circles
Gold & Silver Circle Honorees
2022 Silver Circle Inductees
2021 Silver Circle Inductees
Nomination Form
Education
2023 Student Awards Call For Entries
2023 STUDENT AWARDS:
ENTER HERE
Scholarship Information
Student Awards Archives
2022 Student Award Nominees & Winners
2021 Student Award Nominees & Winners
Continuing Education Grant for Professionals
About
Contact Us
Mid-America Emmy
®
Region
Board of Governors
NATAS Mid-America Foundation
GOLD & SILVER CIRCLE
NOMINATION FORM
Fill out my
online form
.
Fill out my Wufoo form!
GOLD & SILVER CIRCLE
NOMINATION FORM
Name
Address
City
State
ZIP
Day Phone
Evening Phone
Employment Status
----
Employed
Retired
If employed, list current place of employment
The following items must be attached and completed in full or the application will be disqualified.
PLEASE NOTE: only files with .doc .docx and .pdf extensions may be uploaded.
1.
Letter stating why candidate is deserving of induction into Gold/Silver Circle
®
.
Please craft this letter so those who may not know the candidate get a sense of who this person is, along with two letters of recommendation.
File 1
2.
A comprehensive biography that outlines the nominee’s career path, work in the Mid-America area, involvement in organizations associated with the medium and key accomplishments.
Employment history and dates must be included.
File 2
3.
First Letter of Recommendation:
File 3
4.
Second Letter of Recommendation:
File 4
Submitted By
Contact Phone Number
Email Address
SEND