U.S. Department of State

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U.S. Department of State Speaker Invitation
This form is not intended for use in extending invitations to the Secretary of State.
In order to do so, please send a formal letter including the event details and contact information via fax to the following number: (202) 647-1579
or via mail to the following address:2201 C Street NW; Washington, DC 20520.

This form is for inviting speakers to events in the United States Only
Upon receipt of this form, a public affairs specialist will contact you to explore the possibility of providing an official to address your event

Please provide your contact information by filling out the form below. (* = Mandatory)

*First Name

*Last Name

*Phone#

*Mailing Address

Line1
Line2
City/	/ State
Zipcode

*E-mail Address

Website Address

Fax#

*Organization

*Event Date

(mm/dd/yyyy)

*Event Start Time

Tip: Type 'A' or 'P' to switch AM/PM

*Event End Time

Tip: Type 'A' or 'P' to switch AM/PM

Event Press Type

*Audience (Anticipated Size)

*Location

City
State

*Would you be able to help off set the cost of travel?

*Enter subject(s) you wish the Department of State speaker to address:

Please Upload any additional information(*must be .doc/.pdf/.rtf/.txt*) |

Tell us any other information that you think would help our speaker in his/her planning; for example, Format(Panel, Keynote,etc.), other confirmed speakers...

Comments

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* = Mandatory

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