Local Broadcast Legends Nomination Form

Local Broadcast Legends Award recipients are honored for their contribution and service to their local communities.  Nominees will be evaluated based on:

1. their influence and impact at their station(s), and
2. their impact on the community or communities they served. 

Nominations can be made by the general public, but all nominations must be supported by the manager of the station or group of which the nominee is or was employed.

To be eligible, nominees must have served a minimum of 20 years at one specific Wisconsin station, or in one specific Wisconsin community or market. 

While this criteria will serve as a guide, the WBA Hall of Fame Committee will make the final determination each year on who will be selected for the Local Broadcast Legends award.

Nominations open Nov. 1 and deadline is Jan. 15. All nominations must be submitted through this form. Honorees will be informed by March 1.

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individual? What business

Name of Nominee *

Nominee's Title/Position/Status *

Nominee's business address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Nominee's business phone *

Nominee's home address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Nominee's email address

Is nomination posthumous? *

• Yes
• No

Name of nearest living family member

Address of nearest living family member

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone number of nearest living family member

Name of station representative supporting nomination *

Station representative's position: *

Station address (if different from nominee's business address)

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Station representative's phone number *

Station representative's email address *

What is one sentence you would use to describe this individual? This sentence might be used on a plaque:

Please provide the following information: 1) Why is the nominee deserving of the award. 2) Examples of the nominee’s support of local community needs and interests as well as their colleagues and station. (Limit 750 words) *

Letters or supporting information may also be provided [PDF} (five-page limit).

Click or drag a file to this area to upload.

Submit