Webform to request a speaker

To complete the form, please fill out all fields marked as required and then click the Submit button. If you leave the page before submitting, your progress will be lost. It should take you approximately 15 minutes to complete this form. Please allow a minimum of two weeks for us to process your request.

Before you begin, be prepared to provide details on:

  • your personal contact information
  • the event time and location
  • the audience type and speaker duties

Successful form submissions will be directed to collaboration@cyber.gc.ca. Please allow a minimum of two weeks for us to process your request.

Contact information

For example: 111-222-3333
For example: name@example.com
Preferred language for communicationRequired field
Preferred language for communication
Preferred language for communication

Event details

Format the date as: mm/dd/yyyy
Format the date as: mm/dd/yyyy - Please allow a minimum of two weeks for us to process your request.
Event formatRequired field
Event format
Event format

Audience details

Audience typeRequired field
Audience type
Audience type
Audience type
Audience sectorRequired field
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector
Audience sector

Speaker details

Speaker topic

What would a Cyber Centre representative speak about?Required field
What would a Cyber Centre representative speak about?
What would a Cyber Centre representative speak about?

Speaker role

How would a Cyber Centre representative participateRequired field
How would a Cyber Centre representative participate
How would a Cyber Centre representative participate
How would a Cyber Centre representative participate
How would a Cyber Centre representative participate
How would a Cyber Centre representative participate
Are you requesting a specific representative?Required field
Are you requesting a specific representative?
Are you requesting a specific representative?

Event access

Who will attend?Required field
Who will attend?
Who will attend?
Open to media?Required field
Open to media?
Open to media?
Open to media?
Will the event be recorded?Required field
Will the event be recorded?
Will the event be recorded?

Other details

Acknowledgement

I confirm and certify that the information I have provided above is true, accurate and complete to the best of my knowledge.Required field
I confirm and certify that the information I have provided above is true, accurate and complete to the best of my knowledge.

Privacy notice

The personal information you provide in this form is collected under the authority of the CSE Act, section 7(1) and 11(1) of the Financial Administration Act, and section 7(1)(a) and section 70 of the Accessible Canada Act. The purpose of collecting this information is to triage requests for speakers for CSE and its Cyber Centre.

The information collected will be used by the Collaboration and Communications teams to determine if an event can be attended by a representative of CSE or the Cyber Centre, and whom is best suited to do so based on the topics being discussed and the audience in question. Providing information to the webform is voluntary. If you choose not to provide the information requested, Communications and Collaboration will not be able to assess your request properly, and we may have to decline your speaker request.

Personal information collected is described in the following Personal Information Bank: PSU 938 (Outreach Activities).

This information is collected and managed in accordance with the requirements of Privacy Act. If you have any questions regarding the handling of your personal information, please contact CSE’s Privacy Office at: PrivacyOffice@CSE-CST.GC.CA. You also have the right to contact the Office of the Privacy Commissioner of Canada regarding the institution’s handling of your personal information.

Date modified: 2024-05-02