Form n//a CISA Speaker Request Form

CISA Speaker Request Form

1670-0047 - CISA Speaker Request Form

CISA Speaker Request Form

OMB: 1670-0047

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CISA SPEAKERS BUREAU

CISA Speaker Request Form
cisa.speakers@cisa.dhs.gov

Event Title:

Techfest 2025

Speaker Requested:

John Bryant

Speech Date:

04/23/2025

Speech Time & Duration:

09:30am / 45 minutes

Origin of Invitation:

Techfest organizer, Angie Armstrong

Event Location:

Manhattan, Kansas

Speech Topic:

Reducing Cyber Risk and Improve Resilience

Presentation Format:

Keynote Speech
Chat

Roundtable

Webinar

■ Other:

Panel

“Fireside” Chat

Breakout presentation

Event Type:

[List event type: conference, meal, small group, etc]

Question & Answer Period:

■ Yes

Will there be a moderator:

15 minutes

No

Yes [List name of moderator, if available]

■ No

Audience:

IT leaders and managers across multiple sectors including SLTT and
private sectors.

Open Press/Closed Press:

■ Yes, open to Press
No, closed to Press

May CISA invite media?

Yes

■ No

Unknown

CISA Speaker Request Form
Speaker Relationship:

[Does the speaker have any existing personal or professional
relationship with the event sponsor, hosting organization, or group
before whom he/she is speaking?]

Surrogate Requested:

N/A

Purpose:

Encourage collaboration, current cybersecurity awareness, and
promote cybersecurity resilience.

Cost of Attendance:

0.00

Event Web Site:

https://www.networksplus.com/announcement/techfest-2025

Event Sponsor:

Networks Plus

For Profit/Not for Profit:
Offer of Payment/
Reimbursement:

For Profit

■ Not for Profit

N/A

Event Agenda:

[Include event agenda with this SRF, with the requested speaking
selection highlighted/in bold]

Disclaimer/Release Form:

N/A

Deadline for Acceptance:

04/11/2025

Honorable Guests Attending: Mitch Holtus
Coordinator Point of Contact: Angie Armstrong, aarmstrong@bluevalleyinc.net, 785-799-3655
Please submit this form and corresponding attachments to cisa.speakers@cisa.dhs.gov.
Please submit speaking requests at least 4 weeks in advance of the event.
Note that confirmation of CISA participation may not be possible until 2 weeks prior to the event in some cases.
OMB No.1670-0047 | Expires July 31, 2025
Privacy Act Statement
Authority: 5 U.S. C. § 301 and 44 U.S.C. § 3101 authorize the collection of this information. Purpose: CISA will use this information to coordinate, support, and track external
speaking engagements for the Cyber/Infrastructure-related speaking requests. CISA will also use the submitted information to identify the most appropriate CISA speaker for
specific speaking engagements if necessary. Routine Use: This information may be disclosed as generally permitted under 5 U.S.C. §552a(b) of the Privacy Act of 1974, as
amended. This includes using the information, as necessary and authorized by the routine uses published in DHS/ALL-002 - Department of Homeland Security (DHS) Mailing
and Other Lists System of Records (November 25, 2008, 73 FR 71659). Disclosure: Failure to provide the requested speaker’s information will result in their inability to
participate in this speaking engagement.


File Typeapplication/pdf
File TitleCISA Speaker Request Form
SubjectCISA, Speaker Request Form
AuthorCybersecurity & Infrastructure Security Agency
File Modified2022-08-09
File Created2022-01-07

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