Chairman Speaker Request Form

OMB Control Number 3133-0211

Please complete and submit this form to request the NCUA Chairman's participation at your upcoming event. For all other speaker requests, please visit the NCUA's Speaker Request Form.

How Speaker Requests are Evaluated

Speaking requests that will require travel from the NCUA headquarters in Alexandria must be submitted a minimum of 90 days in advance for consideration. Internal and external speaking requests that are received less than 4 weeks out from the event date are less likely to be approved.

The NCUA Blackout Periods

Please note that, generally, NCUA staff members do not speak publicly during the week of an NCUA Board Meeting, which typically take place the third Thursday of the month, excluding the month of August. This time is referred to as the NCUA blackout period.

Indicates required field

1. Event Details

Title of Event

Is this meeting being held virtually?

If yes, please choose the platform being used

If this is a virtual event, will this be

Event start date

Event start time

Event end date

Event end time

2. Date and Time of Speaker Participation

Speaker participation date

Speaker participation time

Speaker participation date and time is flexible

3. Location

Please include name and street address of location of where the event is being held

Event city

Event state

4. Event Information

Background or purpose of event

Have you invited any other NCUA representatives to attend the event?

If yes, please specify who else was invited

Proposed role

Proposed length of remarks, panel or chat

Topic(s) to be discussed

Do you anticipate audience Q&As?

If yes, please specify how long the Q&A session will be

Expected number of attendees

Confirmed or other invited speakers or panelists (Please include titles):

Composition of audience (e.g. examiners, academics, business executives, federal employees, think tanks, policy makers, lobbyists, etc.)

Is the media expected to be in attendance?

If yes, which media outlets will be in the audience?

Is the event open to the public?

Proposed agenda (If agenda for this year is unavailable, please provide agenda or link to the agenda for the same event in prior years.)

Will the presentation be recorded or made public?

Will the presentation be webcast?

5. Event Organizer Contact Information

First Name

Last Name

Title

Organization

Address Line 1

Address Line 2

Requestor City

Requestor State

Requestor ZIP

Requestor Telephone

Requestor Cell Phone

Requestor Email

Requester Confirm Email

Privacy Notice

The information you provide will be used to manage the NCUA's participation at events. The NCUA securely maintains all personally identifiable information in its control and only shares it outside of the NCUA if required by law or regulation. For additional information, please contact privacy@ncua.gov.

Last modified on

08/29/24