NCUA Speaker Request: NCUA Board Member

Speaker Request Form: NCUA Board Member

Section 1: Speaker Information

Please provide information to assist in identifying the Speaker for your event or conference.

1. Please provide the name of the NCUA Board Member you are requesting.

2. Have you already contacted the NCUA (Board or Staff) about the event or conference?

   1. Yes

   2. No

• If the selection is yes, please provide the name(s) of the NCUA staff member(s) you contacted:

Section 2: General Event/Conference Details

Please provide details about the event or conference for which the Board Member is being requested. Details related to the specific speaking engagement will be requested in Section 3.

1. Title of the Event/Conference

2. Hosting Organization Name

3. Duration of the Event/Conference (Start/End Date)

4. Event/Conference Format

   1. In-Person

   2. Virtual

   3. Hybrid

• If the selection is in-person or hybrid, please provide the city/state in which the event/conference is being held.

5. Has NCUA participated in the event/conference in the past?

   1. Yes

   2. No

6. Please provide a link to the current or prior event/conference.

7. Please provide the name(s) and title(s) of any additional notable participants or presenters at the conference/event.

8. What day(s) do you require the Board Member’s attendance at the Event/Conference?

9. On what date do you require confirmation of the Board Member’s participation?

Section 3: Speaking Engagement Details

Please provide details about the specific speaking engagement.

1. Date of the Speaking Engagement

2. Speaking Engagement Start/End Time (Inc. Time Zone)

3. Speaking Engagement Format

   1. In-Person

   2. Virtual

4. Speaking Engagement Type

   1. Opening/Closing Remarks

   2. Keynote Speech

   3. Fireside Chat

   4. Panel Discussion

   5. Podcast

   6. Interview (Media)

   7. Other

5. Primary Target Audience

   1. Credit Unions/Members

   2. Trade Organizations

   3. Regulators/Policymakers

   4. Academics/Researchers

   5. Federal Employees

   6. General Public

   7. Other

6. Estimated Number of Attendees

   1. 0 – 49

   2. 20 – 50

   3. 51 – 99

   4. 100+

7. Proposed Topic

   1. Central Liquidity Fund

   2. Digital Assets and FinTech

   3. Examinations

   4. Fraud

   5. Regulatory Issues and Deregulation

   6. State of the NCUA

   7. Supervisory Priorities

   8. Other

Section 4: Requestor Information

Please provide your details below.

1. Name

2. Title

3. Organization

4. Email

5. Phone Number

6. Please provide any additional information you’d like to share.

Privacy Notice

The information you provide will be used to manage the NCUA's participation at events. The NCUA securely maintains all personally identifiable information in its control and only shares it outside of the NCUA if required by law or regulation. For additional information, please contact [email protected].