Outside Speaking Engagement Form

Collects details for employee outside speaking engagements, including event topic, compensation, review, and disclosure information for compliance and conflict-of-interest assessment.

Employee Information

• Employee name
• Work email
• Department
• Job title

Engagement Details

• Type of engagement
• Event name
• Event organizer / host
• Event date
• Event location
  Enter the city, state/province, or virtual platform name.
• Audience description
  Briefly describe who will attend and whether the audience includes customers, competitors, vendors, students, or the general public.
• Topic summary
  Summarize the speaking topic and any company-related themes, products, services, or industry issues that will be discussed.

Compensation and Benefits

• Will you receive any compensation or value for this engagement?
• Type of compensation
• Estimated compensation amount
  Enter the estimated total value in your local currency.
• Describe any other benefits

Conflict-of-Interest Review

• Will you use the company name, logo, or your company title in the engagement materials or introduction?
• Will you discuss company products, services, clients, vendors, or confidential information?
• Is the organizer, sponsor, or audience a competitor, vendor, customer, or potential business partner?
• Describe any potential conflict of interest
• Has the organizer requested prior approval, a review, or a non-disclosure agreement?

Disclosure, Consent, and Certification

• I understand that this disclosure may be reviewed by HR, Legal, Compliance, or my manager and that additional information may be requested.
• I certify that the information provided is accurate and complete to the best of my knowledge.
• Employee signature
• Submission date