Silver Circle Nomination Form


Induction of 2017 Silver Circle Members will take place at our Emmy ® Gala on September 9, 2017 at The Hershey Lodge in Hershey, PA. The Mid-Atlantic Chapter of the National Academy of Television Arts & Sciences accepts nominations for the prestigious Silver Circle Society. Any NATAS member may submit candidate names by using the form below. Nomination forms are due by March 31 of each year for that year’s awards.

To give the committee the best possible consideration, supplement this nomination form with:

– Details about specific career achievements
– Include importance of jobs in the Mid-Atlantic Region
– Letters in support of the nominee from peers, community members, etc.

The Silver Circle Award recognizes individuals who have outstanding service in broadcasting for a minimum of 25 years, with the majority of it being spent in the Mid-Atlantic Chapter. We accept nominations from broadcast journalism, talent, creative, technical, education, administrative and TV commercial production.

Send nominations to

NAME OF NOMINEE                                                                                                                     

ADDRESS                                                                           CITY/STATE                                      

DAYTIME PHONE                                                            EMAIL                                                

YEARS IN THE INDUSTRY                   YRS IN THE MID-ATLANTIC REGION                         

CURRENT JOB TITLE                                                                                                                   

EMPLOYMENT HISTORY   _____________________________________________________




COMMUNITY/OTHER  _________________________________________________________

SUBMITTED BY                                                           TELEPHONE                                           

EMAIL (for questions)                                                                                                                                             

((If needed, please use additional pages to list special achievements/notes))

TOTAL NUMBER OF ADDITIONAL PAGES ________________________1