Gold & Silver Circle Nomination Form

The Gold and Silver Circle Award is a special recognition of the National Academy of Television Arts and Sciences to honor veteran television professionals who have made a significant contribution to television in Cleveland, Akron, Canton, Erie, Toledo, Youngstown, Bloomington, Ft. Wayne and Indianapolis. The Award is open to everyone who has worked in the television industry for fifty years for the Gold Circle Award or twenty-five years or more for the Silver Circle Award with the majority of that time spent in one or more of the Lower Great Lakes Chapter markets listed above. We encourage nominations from all areas of TV including talent, creative, technical, administrative, production, etc, as well as peripheral areas directly related to television such as TV commercial production, TV education, TV journalism, etc. The honor of the Gold or Silver Circle induction is not presented posthumously. The candidate does not need to be a current member of NATAS to be nominated or elected to receive this recognition.

Candidates or their nominators should complete and submit the following information for evaluation by the NATAS Board of Governors. You may nominate as many individuals as you wish. All nominations for the 2016 induction must be received at the Lower Great Lakes Chapter office not later than 5:00 p.m. (EDT) February 19, 2016. Honorees will be enshrined at the 47th Anniversary Emmy Awards Gala on Saturday, June 18, 2016 at Kalahari Resort in Sandusky, Ohio.

Award Nominated for: 
Nominee First Name:*
Nominee Middle Init.:
Nominee Last Name:*
Nominee Address:      
Nominee Address, line 2:     
Nominee City:     
Nominee State & Zip:
  Zip:
Nominee Home Phone: 
Nominee Cell Phone:
E-mail Address:      
Years in TV:
Date of first job in TV: 
First job in TV:
Present Occupation: 

Employment History of Nominee:
List cities, dates, and places employed within the chapter area over the course of nominee's career.

Nominee Bio:
Below please submit a single-page bio of the nominee that describes their history in communication and broadcasting. The bio should be no more than 600 words in length (you can monitor your word count to the bottom left of the editor). You can also paste text directly from Word by clicking the Paste From Word icon (middle row toolbar, 5th icon from the left).
Submittor First Name:*
Submittor Last Name:*
Submittor Phone:* 
Submittor E-mail: *     
Enter the Security Code Shown Below:
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