CDC Director: Speaker Request | About

Requesting the CDC Director:

Please review the CDC Speakers Bureau Privacy Policy to understand how we use the information gathered to completed speakers requests.
Simply complete all of the fields in the CDC Director speaker request form below and press the submit button. A CDC representative will review your request and contact you.
We appreciate you making every effort to submit this form at least 60 days before your event (and a maximum of 6 months prior to your event). Requests of extremely short notice (within 30 days of the event) may not be processed since it will not allow for adequate staffing coordination.
If you have any questions or concerns, please contact the Speakers Bureau.

Please Note:

Due to technical difficulties, if you submitted a request between 11/8/2018 and 1/2/2018 and have not heard back, please contact the Speakers Bureau.

Event Overview

Event Title:

Name of Organization Hosting Event

Description of Organization:

Event Location (city/state/venue)

Event Date: (minimum 60 days from today; maximum 6 months from today)

*Event start time:

*Event end time:

*Director's participation requested start time:

*Director's participation requested end time:

Contact Person:

Contact Office Phone:

Contact Cell Number:

Contact Email:

Event Details

What is the purpose of this event?

Proposed role of the CDC Director:

If the Director is unable to attend, would you be interested in hosting another CDC speaker? Yes No

If the Director is unable to attend in person, would joining by video teleconference be an option?

Yes

If the Director is unable to attend in person or by video teleconference, would a pre-recorded message be an option?

Yes

Presentation Details

*Topic of Presentation:

*Type of Presentation:

If panel, please provide a list of other invited and/or confirmed panelists.

Please identify any other speakers from CDC requested for this event.

*Length of Requested Presentation:

PowerPoint Requested:

Yes

Will there be a Q&A:

Yes

Remarks If you have requested the Director to provide remarks or give a presentation, please indicate the specific topic/points you would like the Director to address.

*Audience and Key Participants:

*Audience Size:

Expected Media Coverage:

Yes

Will this event be videotaped?

Yes

Additional details? Additional details?

Form Validation

Page last reviewed: August 24, 2018

Content source: Centers for Disease Control and Prevention