U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Speaker Request Form

(Please submit request at least 8 weeks prior to your event.)

Thank you for your interest in the Office of Disease Prevention and Health Promotion (ODPHP) or the President's Council on Sports, Fitness & Nutrition (PCSFN).

If you would like to invite a member of the ODPHP staff or a PCSFN member to participate in your event, please fill out the form below. Please submit your requests at least 8 weeks before your event to allow ample time for processing and scheduling. Note that we can't honor requests for fundraising or meet-and-greets.

Please provide as much of the requested information as possible to help our team make a decision. You may also submit a formal letter of invitation or supporting documents.

Due to the high volume of requests, please await our response to your invitation. You will receive confirmation or declination within 4 weeks of submitting this request. If we are able to meet your request, we will contact you to discuss further details.

OMB Control Number: 0990-0281; Expiration Date: 10/31/2024

What is the requested topic?
(Please select all that apply.)
Have you been working with an ODPHP staff member or PCSFN member on this request?

EVENT INFORMATION

(mm/dd/yyyy)
(Please provide event location details.)
Is the event open to the press?
Are federally registered lobbyists or federally registered lobbying organizations invited to the event?
(Ex: Free / $100.00)
Will there be any fundraising at this event?

ORGANIZATION INFORMATION

(Ex: 760-555-1212)
You may submit a formal invitation or supplemental materials that could be useful as we review your request.
Maximum 5 files.
2 MB limit.
Allowed types: pdf, doc, docx.
* Required

Following Up:

We will confirm or decline requests for a PCSFN member or ODPHP staff member to attend your event within 4 weeks of receiving your invitation.

You should not include ODPHP or PCSFN in any promotional materials for your event until we confirm that a member of the Council or our staff will be able to attend. You also should not list a PCSFN member or staff as "invited" until we confirm attendance.

Additional Questions:

If you have additional questions, please use the contact form on the ODPHP website.