Speaker Request Form

Speaker Request Form

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Organization __________

Organization/Event Point of Contact (Name/Email/Phone number) __________

Event title __________

Please provide detailed description of event __________

Date of Event (if multiple days, please include) __________

Specific time for Principal participation (include time-zone) (optional) __________

Deadline for Acceptance __________

Event location (City/State) __________

Room (optional) __________

Room Setup (optional) __________

If virtual, please indicate __Yes/No___

If unable to attend live, will you accept recorded remarks __Yes/No___

Principal’s role(s) __Keynote/Panelist/Grant announcement/Congressional request/Other…__

What is the goal/objective with the principal’s participation __________

If principal is unable to attend; is a surrogate desired? __Yes/No___

VIPs Invited/Confirmed __________

Expected Audience Size __________

Expected number of U.S. Govt. Employees (including members of Congress and their staff) expected __________

Brief Description of Non-Federal Attendees (e.g., industry representatives, trade association members, think tanks, academia, media, foreign government officials __________

Q&A session __Yes/No___

Open Press __Yes/No___

Bio/Photo needed __Yes/No___

Please provide any additional pertinent information for the event (i.e., agenda, website, etc) __________

EDA Scheduling Policy

1. We are unable to commit to events or requests more than eight weeks in advance. Please plan accordingly.

2. Also note that prior to including mention of any EDA principal in event-related materials, please contact John Atwood of EDA’s Public Affairs Division for approval at [email protected].

3. Please keep in mind that subject to official duties and unforeseen events, we may need to rearrange the schedule, if conducive to the event. Also, due to multiple responsibilities and other factors, it is always a possibility that the requested principal may not be able to participate as planned. In such cases, we respectfully request your understanding and apologize for any inconvenience this may cause.

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