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OCIO Speaker Request Form








  
  
    

  
      



Thank you for contacting the Office of the Chief Information Officer (OCIO). We appreciate your interest in inviting an OCIO Official to speak at your event. OCIO requires that you submit this form at least **45** days prior to your deadline to receive speaker confirmation.

In addition to submission of the OCIO Speaker Request Form, OCIO requires you to email a formal letter of invitation on your organization’s letterhead to OCIO.HHS@hhs.gov.  Please also attach and include draft agenda and any additional supporting material when possible.  Note that we will not begin processing until both the OCIO Speaker Request Form and formal letter of invitation are received.

**Please do not attempt to contact OCIO employees directly.**

Fields marked with an asterisk (*) are required.
                        Terms & Conditions
    Terms & Conditions

OCIO will confirm or decline requests for the Official's attendance at your event approximately 1-month to 6-weeks prior to the date of the event.

You may not include the OCIO Official’s name, title, and/or photo in any materials until we confirm attendance.  You also may not list the OCIO Official as "invited" until we confirm attendance.

**SPEAKING ENGAGEMENTS OR APPEARANCES BY OCIO: INFORMATION FOR OUTSIDE ORGANIZATIONS CONCERNING PROHIBITED GIFTS**

Organizations that invite OCIO Officials to speak or otherwise participate in their events or activities often ask whether gifts or other tokens of appreciation are permissible.  An Executive Order precludes, subject to certain exceptions, OCIO Officials from accepting gifts valued at any amount from registered lobbyists and lobbying organizations.  Gifts received from media organizations, or 501(c)(3) nonprofit organizations are not subject to the lobbyist gift ban provided that the employee of the organization offering the gift is not him or herself a registered lobbyist.  In addition, federal ethics regulations prohibit, subject to certain exceptions, any federal government employee, including OCIO Officials, from personally accepting honoraria, gifts, favors, opportunities, benefits, discounts, or other items of value worth more than $20 that are offered because of official position or tendered by those who may have matters before the Department.  The following items, however, may be offered and accepted without regard to the $20 limit or the lobbyist gift ban, except where noted in *italics*.

Modest items of food and refreshments, such as **soft drinks, coffee, and donuts,** offered other than as part of a meal.
	**Food, refreshments, and entertainment** offered in a group setting with other attendees at an event or conference at which OCIO Officials will deliver official remarks as a**speaker or panel participant**, if provided by the sponsoring organization on the day of the OCIO Official’s presentation.
	**Food, refreshments, and entertainment at a widely attended gathering** for which there is an agency interest in the OCIO Official’s attendance, if the invitation has been tendered directly by the sponsoring organization that is holding the event.  An invitation from a third party who has purchased tickets to the event cannot be accepted unless more than 100 persons will attend, and the market value of free attendance is $350 or less.  *Complimentary widely attended gathering invitations from registered lobbyists or lobbying organizations, other than nonprofit or media organizations may****not****be accepted.*
	**Plaques, certificates, and trophies** that are intended solely for presentation and that have little intrinsic value are acceptable tokens of appreciation.  (Note that art objects, glass works, sculptured trophies and similar items that have residual value or utility, even where diminished by an engraving, logo, or other marking, may not be accepted personally as a token of appreciation.  Under certain circumstances, such valuable items may be presented to OCIO Officials, but these gifts must be treated as gifts to the Department for retention or display in accordance with applicable regulations.)
	**Native artwork, crafts**, or other items representative of traditional native culture offered by **Indian tribes or Alaska native villages** that do not exceed **$200** in value.  (Note that if the tribe or village has specific matters presently pending for decision by OCIO, then acceptance is permitted only upon a written determination of agency interest.)
	**Food, refreshments, and entertainment**, as well as**tangible items of appreciation,** valued at **$350** or less offered by foreign **governments, foreign political parties, and international or multinational organizations** of which the United States is a member.  Tangible items exceeding $350 may be accepted on behalf of the Department for retention or display in accordance with applicable regulations.
	**Food, refreshments, and entertainment** at a meeting or event in a **foreign country** attended by foreign nationals and offered by persons or organizations other than a foreign government, if the value does not exceed the Department of State’s maximum per diem rate for that area.  *Complimentary hospitality tendered in a foreign country by registered lobbyists or lobbying organizations, other than nonprofit or media organizations may not be accepted.*Other rules apply to honorary degrees and awards for meritorious public service or achievement that include gifts of monetary value or that are signified by presentation items other than plaques, certificates, or trophies.  These situations must be reviewed and approved in advance by the Department.  Your assistance in ensuring compliance with these requirements will avoid an awkward or embarrassing situation in which items tendered impromptu must be declined or returned.  Your cooperation in advising OCIO of any proposed gifts is appreciated.
  





Section 1: Speaker Information
        
Speaker Requested
*




- Select -Chief Information OfficerDeputy Chief Information OfficerExecutive OfficerChief Information Security Officer, & Executive Director, Office of Information SecurityExecutive Director, Office of Enterprise ServicesExecutive Director, Office of OS OperationsExecutive Director, Office of Application & Platform SolutionsChief Data OfficerChief Artificial Intelligence OfficerOther

If other, please list position/person

Would you be willing to accept a surrogate speaker?
*




- Select -YesNoSection 2:  Inviting Organizing & Coordination Point of Contact (POC)
        
Inviting Organization:
  *

Is the organization a 501(c)(3)?
*




- Select -YesNo

Organization Description:  
  *

Organization Website:
  *

Event Sponsor(s):
  *

POC Name:
  *

POC Title:
  *

POC Email Address:
  *

POC Office Phone:
  *

POC Mobile Phone:
  *Section 3:  Event Details
        
Event Name/Title:
  *

Event Type: 
*




- Select -ConferenceSummitMeetingBriefingReceptionAwards CeremonyRetirementWebinarRoundtableOther

If other event type, please list:

Address Type:
*




- Select -Keynote Address (Plenary Session)RemarksPanel DiscussionRoundtable DiscussionFireside ChatBreakout SessionOther

If other address type, please list:

Event Topic:
  *

Event Description
  *

Event Purpose/Goal
  *

Event Location/Address or Virtual:
  *

Event Start Date:
  *

  
    
    




Click calendar icon to select start date (mm/dd/yyyy).

Event End Date:
  *

  
    
    




Click calendar icon to select end date (mm/dd/yyyy).

Event Time Zone:
*




- Select -Eastern Time (ET)Central Time (CT)Mountain Time (MT)Pacific Time (PT)Alaska Time (AST)Hawaii-Aleutian Time (HAT)

Event Website
  *

Is there a fundraising component to the event?  
*




- Select -YesNo

Is an award, certificate, gift or other item being presented to the speaker?
*




- Select -YesNo

If there is an award, certificate, gift, or other item, please indicate whether it is being given to the recipient “personally” or “on behalf of HHS.”




- Select -Not ApplicablePersonallyOn Behalf of HHS (not allowed for OCIO employees)

If there is an award, certificate, gift, or other item, what is the approximate value of said gift?

Do any promotional materials for the event include the speaker’s name?
*




- Select -YesNo

What is the cost of attendance for a member of the general public through ticket or registration fee?
  *

If there is no publicly available ticket price or registration fee, what is the cost per person for the event organizer to host the event?
  *

Are there any separately ticketed portions of this event or meals or activities that are not included in the registration fee?
*




- Select -YesNo

Do you understand that the OCIO speaker may only accept free attendance on the day of the speaking engagement?
*




- Select -Yes, I understand.No, I don't understand.

If this is a multiple day event, and the OCIO speaker is invited to participate on his/her/their non-speaking days, what is the cost of attendance for those non-speaking days?Section 4:  Presentation/Speech Details
        
Proposed Speaking Topic(s):
  *

Speaking Date:
  *

  
    
    




Click calendar icon to select date (mm/dd/yyyy).

Deadline Date to Receive Speaker Confirmation:

  
    
    




Click calendar icon to select date (mm/dd/yyyy).

Speaking Start Time:
  *

        




Click clock icon to select start time (hh:mm).

Speaking End Time:
  *

        




Click clock icon to select end time (hh:mm).

Speaking Duration:
*




- Select -5 minutes10 minutes15 minutes20 minutes30 minutes45 minutes60 minutes

Is the speaking time flexible?
*




- Select -YesNo

Q&A Duration:
*




- Select -5 minutes10 minutes15 minutes

Other Speakers or Panelists:Section 5:  Audience Profile
        
Audience Size:  
*




- Select -1-910-5051-100101-150151-200201-500501-10001000+

Audience Composition:
  *

Distinguished Guests:

Other HHS Officials Speaking at the Event:

Registered Lobbyists:

Is membership required to attend?
*




- Select -YesNo

Is the event open or closed?  
*




- Select -Open to the general publicAvailable through invitation onlySection 6:  Media/Press
        
Formally Recorded or Published?
*




- Select -YesNo

Will there be press coverage?
*




- Select -Open to PressClosed to PressInviting Specific Press

What types of media are invited to the invent?
*




Media Not InvitedBroadcastPrint and/or WebLocalRegionalNationalLive WebcastSection 7: Additional Questions for Ethics Approval
        
What is the purpose of this engagement?
  *

What is the benefit to HHS?
  *

What capacity will the requested speaker be participating (e.g. speaker, panelist)?
  *

What specifically will the requested speaker be asked to speak about (e.g. initiative, policy, etc.)?
  *

Please acknowledge that you understand that OCIO speakers are strictly prohibited from sharing nonpublic government information.
*




- Select -Yes, I understand.No, I don't understand.

Does this speaking engagement tie into the HHS and/or OCIO mission? And if so, how?
  ***Reminder - Please remember to email a formal letter of invitation on your organization’s letterhead to OCIO.HHS@hhs.gov. Note that we will not begin processing until both the OCIO Speaker Request Form and formal letter of invitation are received.**

                    
  


Content created by Office of the Chief Information Officer (OCIO) Content last reviewed June 29, 2023 Back to top
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