CDC Director: Speaker Request

Requesting the CDC Director:
  1. Please review the CDC Speakers Bureau Privacy Policy to understand how we use the information gathered to completed speakers requests.
  2. 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.
  3. 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.
  4. If you have any questions or concerns, please contact the Speakers Bureau.

Event Overview

Event start time
Event end time
Director's participation requested start time
Director's participation requested end tim

Event Details

Proposed role of the CDC Director
If the Director is unable to attend, would you be interested in hosting another CDC speaker?
If the Director is unable to attend in person, would joining by video teleconference be an option?
If the Director is unable to attend in person or by video teleconference, would a pre-recorded message be an option?

Presentation Details

Topic of Presentation
Topic of Presentation
Type of Presentation
If panel, please provide a list of other invited and/or confirmed panelists.
Length of Requested Presentation
PowerPoint Requested:
Will there be a Q&A:
Remarks
Expected Media Coverage:
Will this event be videotaped?
Additional details?
Form Validation
Page last reviewed: September 24, 2019