National Museum of the United States Army

U.S. Army Museum Speaker Request Form

First Name This field is required.

Last Name This field is required.

Phone Number This field is required.

Email Address This field is required. Please enter a valid email address.

POC First Name ( if different from requester first name) This field is required.

POC Last Name ( if different from Requester First Name) This field is required.

POC Phone Number (if different from Requester Phone Number) This field is required.

POC Email (if different fromRequester Email) This field is required.

Event Title This field is required.

Event Host Organization Name This field is required.

Event Host Organization Address Street This field is required.

Event Host Organization Address City This field is required.

Event Host Orgnization Address State This field is required.

Event Host Organization Address Zip This field is required.

Event Host Organization Phone This field is required.

Event Host Organization Website URL This field is required.

Event Host Organization Type (registered Lobbyist , 501(c)(3), Media, For-Profit, Nonprofit, MSO/VSO, Army,DoD, Federal Gov, Local gov, congress, Academia, industry, Community Group, Other This field is required.

Event SPONSOR Organization Name (if different from HOST) This field is required.

Event SPONSOR Organization Address Street This field is required.

Event SPONSOR Organization Address City This field is required.

Event SPONSOR Orgnization Address State This field is required.

Event SPONSOR Organization Address Zip This field is required.

Event SPONSOR Organization Phone This field is required.

Event SPONSOR Organization Website URL This field is required.

Event SPONSOR Organization Type (registered Lobbyist , 501(c)(3), Media, For-Profit, Nonprofit, MSO/VSO, Army,DoD, Federal Gov, Local gov, congress, Academia, industry, Community Group, Other This field is required.

Type Yes or No : Is there any other type of sponsorship as part of this event? This field is required.

If yes , enter type of sponsorship ( i.e., table sponsorships) Provide details This field is required.

Location of event Building, room name, number This field is required.

Location of Event Address Street This field is required.

Location of Event Address City This field is required.

Location of Event State This field is required.

Location of Event Zip Code This field is required.

Location of event Country This field is required.

Event Website URL This field is required.

Date of Event This field is required.

Start Time of event This field is required.

End Time of event This field is required.

Description of Event This field is required.

Objective or Purpose of event This field is required.

Theme of Event This field is required.

Type Yes or No: Does the organization have an agreement with the Army or DoD? This field is required.

If Yes, give explanation. This field is required.

Type Yes or No: Has the U.S. Army Museum supported this event or ogranizaion previously? This field is required.

If yes, give explanation of how. This field is required.

Type Yes or No: Does this event qualify as a conferance? This field is required.

Type of speaker requested ( type virtual, in-person or hybrid) This field is required.

Name of Speaker This field is required.

Suggested length of remarks? This field is required.

Arrival time of speaker for event This field is required.

Scheduled begin time of speaker This field is required.

Suggested Topic of Speaker This field is required.

Function of the speaker ( Speech, Dedication, Panel Discussion, town Hall Dialogue, other) This field is required.

If function is other, enter explanation. This field is required.

Type Yes or No: Is Power point Presentation expected? This field is required.

Type Yes or No: will there be Q&A? This field is required.

What type of audio-visual equipment will be available? This field is required.

Type Yes or No: will the speaker's remarks be recorded? This field is required.

Type Yes or No: Will the speaker's biography and/or photo be use in event materials? This field is required.

If Yes, give explanation This field is required.

Event Demographics : Enter the estimate size of the vent ( 10-50, 51-100, 101-300, 301+) This field is required.

Event Demographics: Enter the expected audience profile ( Industry, Congress, Local Government, Federal Gov, DoD, Army, Academia, Nonprofit, Private Sector, Corporation, VSO/MSO, media, Community Grouop, other) This field is required.

Event Demographics: If other, enter explanation. This field is required.

Event Demographics: If limited event attenadance, list specific organization: This field is required.

Event Demographics: Please list names and titles of other speakers. This field is required.

List total number of speakers invited and/or confirmed to participate This field is required.

List Confirmed Army/DoD speakers This field is required.

Type Yes or No: will there be VIPs or senior leaders attending the event This field is required.

Please indicate which type of senior leaders will be attending the event. This field is required.

Type Yes or No: Will there be VIPs or senior leaders presenting at the event This field is required.

Please indicate which type of senior leaders will be presenting at the event. This field is required.

Please list distinquished guests expected to attend. This field is required.

Type Yes or No: Is this event open to the press? This field is required.

If yes, please indicate which media outlets are invited. This field is required.

Type Yes or No: Will the event be broadcasted or live streamed? This field is required.

If Yes, please provide details ( television, radio, podcast, social media, etc) This field is required.

What is the dress code for this event? ( civilian formal, uniform dress, uniform ACUs, civilian business casual, casual) This field is required.

Type Yes or No: If there a fee for attending this event? This field is required.

If Yes, what is the fee? This field is required.

Type Yes or No: Are any complimentary items offered to speakers? This field is required.

If Yes, list items ( ie, travel reimbursement, meals, alcoholic beverages, gifts, awards, free attendanc) This field is required.

If Yes, please provide total monietary values of these items for government ethics information This field is required.

Type Yes or No: Is this a fundraising event? This field is required.

If Yes, please provide details This field is required.

Type Yes or No: Are any other organizations payoing for travel or travel-related expenses? This field is required.

Type Yes or No: Is admission, seating, and all other accommodations conected with the event available to all military servic ememebers? This field is required.

Please provide any other informationthat may help to clarify your request. This field is required.

Please attach an even t agenda and a detailed event description/agenda to this request. This field is required.

Speaker Response needed by This field is required.

Form must have at least one input.

All required fields must have input.

Submit

Visit the Museum

Exhibits

Public Programs

Programs & Education

Events

News and Articles

About Us

Get Involved