CBA Hall of Fame Application

Name of Nominee(Required)

First Last

Media Nominee Worked In:(Required)

Radio

Television

Both

Total No. of Years Worked in Colorado Broadcasting(Required)

Provide total number of years. Does not need to be consecutive.

Status:(Required)

Living

Deceased

Nominee's Contact Information

Nominee's Email(Required)

Nominee's Phone(Required)

Nominee's Address(Required)

Street Address Address Line 2 City State ZIP Code

Primary Contact Information for Deceased Nominee

Primary Contact Name(Required)

First Last

Primary Contact Relationship(Required)

(i.e. spouse, friend, etc.)

Primary Contact Email(Required)

Primary Contact Phone(Required)

Primary Contact Address(Required)

Street Address Address Line 2 City State ZIP Code

Nominee Information

Nomination Type(Required)

Self Nomination

Nominator

Choose whether you're "Self Nominating" or nominating someone else "Nominator"

Nominator Name(Required)

First Last

Nominator Email(Required)

Nominator Phone(Required)

Nominee Details

Nominee's Work History(Required)

Company/Call Letters

Position Held

Year Started

Year Ended

Use + at end of row to add more history

Description of Merit

Contributions to Profession:(Required)

Broadcast Career Highlights:(Required)

Broadcast Recognition & Awards:(Required)

Local, State, or National Broadcast Activities:(Required)

Community Service:(Required)

Reason Nominee Should Be Chosen:(Required)

Supporting & Additional Material Uploads

Nomination must include two (2) signed recommendation letters, each not to exceed 1 page in length.

Additional supporting documentation such as certificates, photographs, etc. may be uploaded.

Recommendation Letters(Required)

Drop files here or

Accepted file types: pdf, doc, Max. file size: 32 MB, Max. files: 2.

Upload two (2) signed recommendation letters here in PDF or DOC format.

Additional Materials

Drop files here or

Accepted file types: (iejpg, gif, png, pdf), Max. file size: 32 MB, Max. files: 3.

(optional) up to three (3) additional supporting documents