Request a Speaker from CIRT

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Event Details

Event Name:

Location:

Date:

Name of Requesting Entity:

Speech Time

Duration: Minutes

Speech Details

Topic:

Type:

Question & Answer Period:

Moderator/ Master Ceremonies:

Audience Information

Audience:

Anticipated number of attendees, background and demogrpahics

Will the Press be attending?

May CIRT invite press?

Event Logistics

Event Purpose:

Event Web Site:

Profit/Non Profit:

Additional Information

Deadline for Acceptance:

Upload Agenda

One file only.
2 MB limit.
Allowed types: pdf.

Upload Disclaimer/Release Form:

One file only.
5 MB limit.
Allowed types: pdf.

Coordinator/Point of Contact

Name:

Email:

Phone:

Submit speaking requests at least 4 weeks in advance of the event. Confirmationof CIRT Div. participation may not be possible until 2 weeks prior to the event.

Privacy Statement

Authority: The collection of this information is authorized by the Cyber Incident Response framework.
Purpose: CIRT Div. will use this information to coordinate, support, and track external speakingengagements.
Disclosure: Providing this information is voluntary; however, failure to do so mayresult in the inability of the CIRT Div.to participate in the speaking engagement.