Speaker Request

Thank you for your interest in having a TSA speaker at your event. In order to help us facilitate your request, please complete and submit the following form and any corresponding attachments at least 30 days prior to the event, and allow 10 business days for decisions to be made.
For questions please email TSASpeakers@tsa.dhs.gov.

Required field =

Coordinator/Point of Contact

Event Info

Event location: Is it a virtual event?
If in person, please provide the name of the venue, and the address, including the street address, city, and state. If virtual, please provide the virtual platform to be used, Zoom, Teams, etc.
Event Type:
Agency Requested Topics:
(Keynote address, roundtable, panel, etc.)
(Will the speech be followed by a Q&A session?)
(Approximate number of attendees, also describe the make-up and if membership is required.)
(List names and titles of members of Congress, CEOs, or other VIPs participating in, or attending the event.)
(Will media be invited to the event? If so, describe and submit a media list.)
(Please include the cost of attendance for audience members, if any; specify whether a release form is required; if travel reimbursement offered, please specify; any other relevant information you would like to provide.)

 

Paperwork Reduction Act Burden: TSA will use the information to collect information on the requestor and the event a speaker would attend. This is a voluntary collection. It is estimated that the total annual burden per response associated to this collection is approximately 10 minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information, unless it displays a valid OMB control number. The control number assigned to this collection is OMB-1652-0075, which expires 08/31/2025. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to TSA PRA Officer, 6595 Springfield Drive, Springfield, VA 20598-6011. ATTN: PRA 1652-007