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National Security Agency/Central Security Service

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# NSA Speaker Request Form

HomeHelpful LinksRequest an NSA SpeakerNSA Speaker Request Form

Please complete this form in its entirety - we cannot process your request until we receive a completed version. If there are fields that do not apply, please type **“N/A”. DO NOT LEAVE IT BLANK** or it will result in non-submission. The form must be submitted **at least 45 days** before the event. Otherwise we cannot guarantee your invitation will be processed in time for a final decision. Information provided in the form may be shared with NSA Speakers Bureau participants or coordinators for coordination purposes. 

After completing this form, please email us **a current agenda** (draft agendas are acceptable) for your event.

**PLEASE NOTE:**                          - The engagement team will always  verify by email when they have received your request .
                          - Submission of this Speaker Invitation Request Form  does not  authorize the requestor to use the name, title, photograph, or biography of the requested speaker as well as the National Security Agency/Central Security Service and U.S. Cyber Command in any form of marketing materials.
                          - Official notification of acceptance or decline will be provided to the requestor upon completion of our legal and public affairs vetting process.

 

# Requestor Contact Information

                                        - Job Title:(Required)  
                                        - Affiliation with Organization:(Required)  
                                        - Phone Number:(Required)  
                                        - Email Address:(Required)  

                                        - Organization Website(Required)  

# Event Information

                                        - Event Name:(Required) 
                                        - Event Website(Required)  

                                        - Event Start Date:(Required) 
                                        - Event End Date:(Required)  

                                        - Type of Engagement:(Required) Class/Seminar ConferencePodcastTradeshowWorkshopRecruitmentOtherIf Other, Please Specify Here:
                                        - Engagement Format:(Required) PresentationFireside ChatInterviewKeynotePanelRoundtableOtherIf Other, Please Specify Here: 

                                        - Event Start Time:(Required)  Use 12 or 24 hour format.
                                        - Event End Time:(Required)  Use 12 or 24 hour format. 

                                        - Speaker Start Time:(Required)  Use 12 or 24 hour format.
                                        - Speaker End Time:(Required)  Use 12 or 24 hour format. 

YesNo

YesNo

YesNo

                                        - Will there be a Q&A?(Required) YesNo
                                        - If yes, will the questions be from:  ModeratorAudienceBoth 

# Audience

YesNo

# Event Logistics

In-Person EventVirtual Event

Civilian AttireUniform

YesNo

# Media

YesNo

YesNo

YesNo

# Sponsorship/Expenses

U.S. GovernmentForeign GovernmentsNon-GovernmentAcademia

YesNo

                                        - Is this event a fundraiser?(Required) YesNo
                                        - If yes, for what organization are these funds being raised?  

Cost to attendees other than a speaker (please provide the highest value/cost of ticket, value/cost of food, and value/cost of beverages for legal analysis, not sufficient for "No cost to government").  Please do not leave this section blank as it is needed by our legal team to provide a proper assessment. If the amount is $0 please enter that in the fields below: 

                                        - Value/cost of ticket/registration:(Required) 
                                        - Value/cost of food/beverages:(Required)  

# Guidelines/Disclaimer

Read the SpeakersNSA Guidelines and select the checkbox below.

I agree to the SpeakersNSA Guidelines

Need Assistance?
If you have any questions or need help completing the Speakers Invitation Request Form, pleasee-mail the SpeakersNSA office.

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##### NSA.GOV

                                - About
                                - Leadership
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                                - Contact NSA 
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                                - Site Policies

##### CULTURE

                                - Core Values
                                - Operating Authorities
                                -  Civil Liberties, Privacy, & Transparency Office 
                                - Compliance
                                - Diversity, Equity, Inclusion, & Accessibility
                                - General Counsel
                                - NSA Inspector General

##### HELPFUL LINKS

                                -  
                                - NSA Freedom of Information Act
                                - Privacy Act Requests
                                - Request a Speaker
                                - Prepublication Review
                                - Media Inquiry
                                - Frequently Asked Questions

##### RESOURCES

                                - Classified Materiel Conversion
                                - Commercial Solutions for Classified Program (CSfC) ​
                                - Cryptographic Support Services 
                                - Media Destruction Guidance 
                                - NSA Open Source

##### RELATED LINKS

                                - DNI.gov
                                - Defense.gov
                                - IC on the Record
                                - Intelligence.gov

                          - NSA.GOV                              - About
                            - Leadership
                            - Cybersecurity Collaboration Center
                            - National Cryptologic Museum
                            - Contact NSA
                            - Accessibility
                            - ABA Notice
                            - Site Policies
                          - CULTURE                              - Core Values
                            - Operating Authorities
                            - Civil Liberties & Privacy
                            - Diversity, Equity, Inclusion, & Accessibility
                            - General Counsel
                            - NSA Inspector General
                          - HELPFUL LINKS                              - NSA Freedom of Information Act
                            - Privacy Act Requests
                            - Frequently Asked Questions
                            - Request a Speaker
                            - Prepublication Review
                            - Media Inquiry
                          - RESOURCES                              - Commercial Solutions for Classified Material (CSFC)
                            - Media Destruction Guidance
                            - Classified Materiel Conversion
                            - Cross Domain Services
                            - NSA Open Source
                            - NSA Exhibit Roadshow
                          - RELATED LINKS                              - DNI.gov
                            - Defense.gov
                            - IC on the Record
                            - Intelligence.gov

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