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  Request an NSA Speaker
  Securing the Future
 
 Our workforce understands the changing pace of technology. We are constantly developing techniques and capabilities that provide timely secure information to the Warfighter and our national leaders. We will continue to research and develop emerging technologies for transforming raw data into actionable information.  Sub-Topics:
 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
 Full Name:(Required) First Name (Required)
 Last Name (Required)
 Organization Website(Required)Event Website(Required)
 Job Title:(Required)Affiliation with Organization:(Required)Phone Number:(Required)Email Address:(Required)
 EVENT INFORMATION
 Event Name:(Required)
 Event Start Date:(Required)Event End Date:(Required) If this is a multi-day request, enter the start and end dates, and provide details in the Logistics Section.
 Describe this Event's Purpose:(Required)
 This Event is Hosted by (Organization):(Required)
 Type of Engagement:(Required)CLASS/SEMINARCONFERENCEPODCASTTRADESHOWWORKSHOPRECRUITMENTOTHERIF OTHER, PLEASE SPECIFY HERE:Engagement Format:(Required)PRESENTATIONFIRESIDE CHATINTERVIEWKEYNOTEPANELROUNDTABLEOTHERIF OTHER, PLEASE SPECIFY HERE:If the event engagement is a panel, who are the other invited panel members?If the engagement format involves a moderator, who will that be?
 AREA OF FOCUS
 Main Speaking Topic Requested:(Required) AcquisitionArtificial Intelligence/Machine LearningBig DataCivil Liberties/PrivacyCommittment to the EnvironmentCryptographyCryptologic CentersCryptologic HeritageCybersecurity PolicyCyber DefenseCyber ThreatsCybersecurity Products and ServicesDevelopment Operations (DevOps)Diversity and InclusionElection SecurityInformation and Communications Technology StandardsIntelligence OversightInternet of ThingsLogistics ManagementMilitary SupportOpen SourceOperational SecurityOverview of U.S. Cyber Command PartnershipPublic/Private PartnershipsTechnology TransferThreat Advisories/Guidance
 Describe Topics and/or Sub-Topics to be Discussed:(Required) Please be specific. What do you want your audience to walk away knowing?
 Will there be a Q&A Session?(Required) Yes  No
 If yes, who will moderate? Please hyperlink a bio, or email a copy to speakersnsa@nsa.gov.
 Requested Speaker (Please specify if you already have a name of someone specific from NSA/CSS).
(Required) If  NONE, list "N/A"
 If the requested speaker is unavailable, is a deferral acceptable?(Required) Yes  No
 If yes, do you have a deferral preference? NOTE: If this section is left blank, we will assume the engagement is not deferrable.
 Have you already invited, or do you plan to invite, other NSA or US Cyber Command speakers?:(Required) Yes  No
 If yes, please provide their names. You must complete a separate form for each Speaker.
 AUDIENCE
 Describe the primary general audience: (Required) ACADEMIA (K-12/COLLEGE/UNIVERSITY)GENERAL PUBLICGOVERNMENT/ELECTED OFFICIALSINDUSTRY PROFESSIONALSPRIVATE INDUSTRYBUSINESS LEADERSOTHER
  Select all that apply. NOTE: Use SHIFT or CONTROL to make multiple selections
 Number of attendees anticipated (in person or virtually during the live session):
(Required) 0-2021-5051-100101-500500+
  Select a range.
 Names and titles of notable individuals confirmed to attend: For Example: Members of Congress, Federal Government Leaders, CEOs, other VIPs
 Notable individuals who are confirmed to participate/speak: Please hyperlink any bios, or email copies to speakersnsa@nsa.gov.
 Has NSA or US Cyber Command participated in the past?(Required) Yes  No
 If yes, please provide the event, dates (month and year), and participant name/affiliation.
 LOGISTICS FOR EVENT
 Deadline for Request Acceptance: (Required) NOTE: Please be advised we cannot guarantee a final decision by the date selected, however we will work to ensure you receive a timely response.
 How will this speaking engagement be delivered? (Required) In-Person Event  Virtual Event
 In-Person Event Venue Address: Building/Room Number/Parking Details
 Street
 City
 N/AAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMinor Outlying IslandsMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming  Region
 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocosColombiaComorosCongo - BrazzavilleCongo-KinshasaCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaS. Georgia and S. Sandwich IslandsSaint Kitts and NevisSaint LuciaSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSoviet UnionSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUS Virgin IslandsUzbekistanVanuatuVenezuelaViet NamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZaireZambiaZimbabwe  Country
 Zip
  If virtual, leave fields blank
 Audio/Visual Capabilities:(Required) Yes  No
 On what platform will the event be hosted?(Required) Please indicate any website(s) to access, software to download, Etc. (type N/A if in person)
 Does the platform require a software client or plugin?(Required) Yes  No
 If yes, please explain:
 What degree of interaction is required during the session (e.g. chat, survey, polling)?(Required)
 Does the platform have any firewall rules in place, and or utilize any port redirection?(Required) Yes  No
 If yes please explain:
 Event Start Time:(Required)Use 12 or 24 hour format.Event End Time:(Required)Use 12 or 24 hour format.
 Speaker Presentation Date:(Required)
 Speaker Start Time:(Required)Use 12 or 24 hour format.Speaker End Time:(Required)Use 12 or 24 hour format.
 Will this time slot include a Q&A Session?(Required) Yes  No
 Event attire required for speaker:(Required) Civilian Attire  Uniform
 If uniform is required, please indicate type:
 Is a speaker bio required?(Required) Yes  No
 Is a speaker headshot required?(Required) Yes  No
 Sponsor Name/Organization:(Required)
 Sponsor Type:(Required) U.S. GOVERNMENT  FOREIGN GOVERNMENT  NON-GOVERNMENT  ACADEMIA
 Is the host organization a non-profit?(Required) Yes  No
 Is this event a fundraiser?(Required) Yes  No
 If yes, for what organization are these funds being raised?
 MEDIA
 Will media/press be in attendance?(Required) Closed to mediaInvited but not confirmedInvited and confirmedMay register but not confirmed/tracked
 If you anticipate media, please include a media/press list (name and organization). Alternatively, you may email a copy to speakersnsa@nsa.gov. A draft list is acceptable, but you must provide the updated list within 15 days of the event to speakersnsa@nsa.gov.
 Will remarks be:(Required) On the record  Off the record
 Will the event be recorded?(Required) Yes  No
 If yes, how will the recording be used, and where will it be published/posted?
 Will the event be live-streamed?(Required) Yes  No
 If yes, what is the intended purpose?
 EXPENSES
 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)$ 
 Specific expenses covered by organizer: Memento, travel expenses, meal, invitation to any reception, etc.
 Guidelines/Disclaimer
 Read the SpeakersNSA Guidelines and select the checkbox below.
 Disclaimer(Required) 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 at SpeakersNSA@nsa.gov
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