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JFHQ-DODIN Speaker Invitation Request Form

JFHQ-DODIN has knowledgeable, engaging speakers who can discuss a wide variety of topics with the community. From general officers to civilian employees, The command offers a wealth of experience in everything from military leadership and traditions to cyber defense capabilities. Whether you need a dynamic keynote speaker to kick off a special event or want to learn more about the Cyber Domain, we can potentially provide a speaker who meets your needs.

To request a JFHQ-DODIN Senior Leader Speaker for your upcoming event, please complete this form in its entirety - we cannot process your request until we receive a completed version.

If there are fields that do not apply, please type “N/A”. DO NOT LEAVE IT BLANK or it will result in a non-submission.

This request process signifies an official request for a speaker. We recommend you submit at least 45 days before the event or we cannot guarantee we will process your invitation in time for a final decision.

After completing this form, please send a current agenda (draft agendas are acceptable) for your event to steven.j.mavica.civ@mail.mil

NOTE: Submission of this Speaker Invitation Request Form does not authorize the requestor to use the name, title, photograph, or biography of the requested speaker as well as U.S. Cyber Command in any form of marketing materials. Official notification of acceptance or decline will be provided to the requestor upon completion of our legal and public affairs vetting process.

EVENT INFORMATION

Event Name:*

Event Start Date and Time:*
Event End Date and Time:*

Requested Speaker Start Date and Time:*
Requested Speaker End Date and Time:*

Describe this Event's Purpose:*

This Event is Hosted by (Organization):*

Type of Engagement:*
CLASS/SEMINAR
CONFERENCE
PODCAST
TRADESHOW
WORKSHOP
RECRUITMENT
OTHER
IF OTHER, PLEASE SPECIFY HERE:
Engagement Format:*
PRESENTATION
FIRESIDE CHAT
INTERVIEW
KEYNOTE
PANEL
ROUNDTABLE
OTHER
IF OTHER, PLEASE SPECIFY HERE:

Notable individuals who are confirmed to participate/speak:

Please hyperlink any bios, or email copies to steven.j.mavica.civ@mail.mil.

REQUEST A SENIOR LEADER SPEAKER

Select Preferred Senior Leadership Speaker:*
Commander JFHQ-DODIN
Deputy Commander
Executive Director
Chief of Staff
Senior Enlisted Leader
Other (Please specify below)
If other, type name and title.
If the requested speaker is unavailable, is a deferral acceptable?
YesNo
Speaker Deferral Choice (Select all that apply):*
Commander JFHQ-DODIN
Deputy Commander
Executive Director
Chief of Staff
Senior Enlisted Leader
Other (Please specify below)
Other Deferral, not in list above:

Have you already invited, or plan to invite other JFHQ-DODIN and or DoD speakers?*

YesNo

If yes, please provide their names. You must complete a separate form for each speaker.

Are spouses or guests invited?*

YesNo

REQUESTOR CONTACT INFORMATION

Affiliation with Organization:*
Job Title:*
Phone Number:*
Email Address:*

Email

Confirm

Full Name:*

First

Last

Organization Website*
Event Website:*

AREA OF FOCUS

Main Speaking Topic Requested:*

Describe Topics and/or Sub-Topics to be Discussed:*

Please be specific. What do you want your audience to walk away knowing?

Will there be a Q&A Session?*

YesNo

If yes, who will moderate? Please hyperlink a bio, or email a copy to CDRInvites@nsa.gov

AUDIENCE

Has JFHQ-DODIN, DISA, and or U.S. Cyber Command participated in the past?*

YesNo

If yes, please provide the event, dates (month and year), and participant name/affiliation.

Describe the primary general audience (Select all that apply): *

NOTE: Use SHIFT or CONTROL to make multiple selections

Number of attendees anticipated (in person or virtually during the live session): *

Select a range.

Names and titles of notable individuals confirmed to attend:

For Example: Members of Congress, Federal Government Leaders, CEOs, other VIPs

LOGISTICS FOR EVENT

Deadline for Request Acceptance: *

NOTE: Please be advised we cannot guarantee a final decision by the date selected, however we will work to ensure you receive a timely response.

How will this speaking engagement be delivered?

In-Person EventVirtual Event

In-Person Event Venue Address:

Building/Room Number/Parking Details

Street

City

Region

Country

Zip

If virtual, leave fields blank.

Audio/Visual Capabilities:*

YesNo

On what platform will the event be hosted?*

Does the platform require a software client or plugin?*

YesNo

If yes, please explain.

What degree of interaction is required during the session (e.g. chat, survey, polling)?*

Does the platform have any firewall rules in place, and or utilize any port redirection?*

YesNo

If yes, please explain.

Will this time slot include a Q&A Session?*

YesNo

Event attire required for speaker:*

Civilian AttireUniform

If uniform is required, please indicate type:

Is a speaker bio required?*

YesNo

Is a speaker headshot required?*

YesNo

Sponsor Name/Organization:*

Sponsor Type:*

U.S. GOVERNMENTFOREIGN GOVERNMENTNON-GOVERNMENTACADEMIA

Is the host organization a non-profit?*

YesNo

Is this event a fundraiser?*

YesNo

If yes, for what organization are these funds being raised?

MEDIA

Will media/press be in attendance?*

If you anticipate media, please include the media/press list (name and organization). Alternatively, you may email a copy to steven.j.mavica.civ@mail.mil.

A draft list is acceptable, but you must provide the updated list within 15 days of the event to steven.j.mavica.civ@mail.mil.

Will remarks be:*

On the recordOff the record

Will the event be recorded?*

YesNo

If yes, how will the recording be used, and where will it be published/posted?

Will the event be live-streamed?*

YesNo

If yes, what is the intended purpose?

EXPENSES

Cost to attendees other than a speaker (please provide the highest value/cost of ticket, value/cost of food, and value/cost of beverages for legal analysis, not sufficient for "No cost to government"). Please do not leave this section blank as it is needed by our legal team to provide a proper assessment. If the amount is $0 please enter that in the fields below:

Value/cost of ticket/registration:*
$
Value/cost of food/beverages:*
$

Specific expenses covered by organizer: *

Memento, travel expenses, meal, invitation to any reception, etc.

Guidelines/Disclaimer

Submission of the request form does not authorize the requestor to use the name, title, photograph, or biography of the requested speaker as well as Joint Force Headquarters - Department of Defense Information Network in any form of marketing materials. Official written notification of acceptance or decline will be provided to the requestor upon completion of our legal and public affairs vetting process. If you plan to send out a press release or advertise an approved speaker, please coordinate with us for approval before releasing.
Speakers cannot participate in any activity that is associated with fundraising, promotional activities or endorsements, either directly or indirectly.
Speakers may not participate in any activity or event that has partisan political affiliation, pursuant to the Hatch Act of 1939.
Speakers cannot participate in any activity in which any group has been unlawfully segregated or unequally treated on the basis of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age (40 or older), disability, or genetic information.
Speakers cannot accept honoraria, stipends, or fees for speaking.

Disclaimer*

I agree to the Speaker Guidelines