NCUA Speaker Request Form_Staff_Redline

Speaker Request Form: NCUA Staff Member

Section 1: Speaker Information

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

1. Are you requesting a specific NCUA staff member to speak at your event or conference?

   1. Yes

   2. No

• If the selection is ‘Yes’, please provide the name(s) of the NCUA staff member(s) you’re requesting:

• If the selection is ‘No’, please provide additional context as to what area of expertise you’re requesting:

2. Have you already contacted a NCUA staff member about your 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 Speaker 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?

a. Yes

b. No

6. If possible, 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 Speaker’s attendance at the Event/Conference?

9. On what date do you require confirmation of the Speaker’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.

Terms and Conditions for Requesting a Speaker from the NCUA

1. Submission of this Speaker Request Form is a request only, and does not imply consent to participate by the National Credit Union Administration. The NCUA will consider each request to determine speaker availability and whether participation is in compliance with the laws, rules, regulations and guidelines governing activities of a federal agency and its employees. If the NCUA agrees to participate in the event, confirmation of its participation will be communicated in writing to the contacts provided.

2. The NCUA must review and approve in advance any public announcement, news release, invitation, promotional material or other information to be released regarding an appearance by its employees at the event. The Requester may not use the name of the NCUA in any way that constitutes or implies endorsement of the Requester, the Requester’s Organization, the event, or any participant or topic connected to the event, by the NCUA or its employees.

3. All press participation must be approved at least two weeks prior to the event by the NCUA. If you indicate in the Speaker Request Form that the event is not open to the press and subsequently open the event to the press, the NCUA reserves the right to cancel its participation in the event.

4. The Requester will inform the NCUA if it intends to record or broadcast NCUA employees, or reproduce or distribute any presentations or program material used by NCUA employees in connection with a speech or public appearance.

5. The Requester agrees to cooperate with the NCUA with regard to security arrangements at the event that may be required by the agency.

6. Employees of the NCUA may not accept compensation (including a gift or honorarium) or reimbursement for travel or lodging expenses in connection with this event.

7. The Requester understands and agrees that any material change to the information provided on the Speaker Request Form or any failure to comply with these Terms and Conditions may result in the cancellation of participation in the event by the NCUA and its employees. The NCUA reserves the right to  cancel its participation in the event.

 I agree to the Terms and Conditions specified above for Requesting a Speaker from NCUA

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].