DEM Senior Leader Speaker Request
Request a Senior Leader from the Department of Emergency Management to speak at a conference, symposium, or panel. The Department of Emergency Management requires 30 days notice to accommodate a speaker/presentation request. All invitations are up to the discretion of the speaker/presenters.
Origin of Invitation [Organization Name]
Type of Organization
For Profit
Not For Profit
Volunteer Organization
Trade Association
Local Government
State Government
Federal Government
International
Other
Organization Point of Contact
Please Select
Name
Title
Email
Phone
Event Name
Event Purpose
Event Webpage
Event Agenda
Speaker Requested
Surrogate Requested
Deadline for Acceptance
Speech Date
Speech Time
Speech Duration
Speech Topic and Specific Topic/Points or Questions to Answer
Presentation Format
Keynote
Roundtable
Panel Discussion
One-On-One Interview
Questions & Answers
Audience (please describe who will be in attendance and the sector or industry represented)
Honorable Guests Attending [List Name, Title, Organization]
Cost of Attendance
Event Sponsors
Open or Closed to Press
Open to press
Closed to press
Submit
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