Response

* Required Field

Event details

Title of event

Please answer the following two questions. If the meeting is not virtual, please choose Not Applicable for the platform.

* Is this meeting being held virtually? YesNo

* If yes, please indicate which virtual platform is being used (Zoom, Blue Jeans, Google Hangouts, Microsoft Teams, Webex etc.)?

* Event start date (MM/DD/YYYY)

Event start time

* Event end date (MM/DD/YYYY)

Event end time

Time Zone

Other Topic

* Have you invited any other USPTO speakers/panelists? YesNo

If yes, please specify other USPTO invited speakers/panelists:

Date and time of speaker participation

Date (MM/DD/YYYY)

Time

Flexible YesNo

Location

Please include full location of the where the event is being held.

City

State

Country

Event Information

* Organization

* Event POC

* Event POC Phone Number

* Event POC Email Address

* Is the host a lobbying organization? YesNo

* Is the host a "For Profit" organization? YesNo

Corporate sponsors (if any)

* Background or purpose of event

If Other, please specify

* Do you anticipate audience Q&As? YesNo

If yes, please specify how long?

Expected number of attendees

Confirmed or other invited speakers/panelists (Please include titles):

* Composition of audience (e.g. patent attorneys, academics, business executives, federal employees, think tanks, policy makers, lobbyists, etc.)

* Is the media expected to be in attendance? YesNo

If yes, which media outlets?

* Is the event open to the public? YesNo

* Is there any fee for attendance? YesNo

If Yes, please indicate the dollar amount?

* Will there be any food/drink provided? YesNo

If yes, please indicate the value:

Proposed Agenda (if no agenda and if possible, please provide agenda or link to agenda for same event in prior year(s)):

Proposed agenda

Upload FileNo file chosen

* If travel expense(s) are being offered, please indicate the nature of the expense. (e.g. ground, airline, hotel, meals).

* Will the presentation be recorded or made public? YesNo

* Will the presentation be webcast? YesNo

* Has the sponsor solicited the participation of USPTO employees in other events within the last 3 years? YesNo

Requester contact information

Prefix

* First Name

* Last Name

Title

* Organization

* Address Line 1

Address Line 2

* City

* State

* Zip

* Phone

Cell Phone

* Email

For more information or questions, please email SpeakingRequest@uspto.gov