AMIA and NATAS Local Television Project Contact Survey.

The Association of Moving Image Archivists and the National Academy of Television Arts and Sciences

Local Television Project Contact Survey.

Who are you?

First Name: Last Name:

Organization:

Who do we contact for additional information?

Same as above? Yes No

If other please enter information below.

First Name: Last Name:

Organization:

Address: Address:

City: State: Zip Code:

Phone: Fax: E-Mail:

Comments, station call signs:

If you wish to provide information on your collection please click HERE.

The information collected by this survey shall only be used by AMIA and NATAS for the purposes of the Local Television Project and not released for any other purpose without permission.

Further information on the Local Television Project can be found at the AMIA website or feel free to contact the Project Manager Sharon Blair.

AMIA and NATAS would like to acknowledge the considerable financial support for this project provided by the NHPRC.

You may print this form and mail it to:

Karen Cariani
WGBH Educational Foundation
125 Western Avenue
Boston, Massachusetts 02134