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Run: Outside Speaking Engagement Form

Use this Outside Speaking Engagement Form to collect the facts HR or compliance needs before an employee speaks publicly. It captures the event, compensation...

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Employee Information

Employee name (required)

Work email (required)

Department (required)

Job title (required)

Engagement Details

Type of engagement (required)

Event name (required)

Event organizer / host (required)

Event date (required)

Event location

Enter the city, state/province, or virtual platform name.

Audience description (required)

Briefly describe who will attend and whether the audience includes customers, competitors, vendors, students, or the general public.

Topic summary (required)

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? (required)

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? (required)

Will you discuss company products, services, clients, vendors, or confidential information? (required)

Is the organizer, sponsor, or audience a competitor, vendor, customer, or potential business partner? (required)

Describe any potential conflict of interest

Has the organizer requested prior approval, a review, or a non-disclosure agreement? (required)

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. (required)

Yes No N/A

I certify that the information provided is accurate and complete to the best of my knowledge. (required)

Yes No N/A

Employee signature (required)

Submission date (required)

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Email (required)

Your name (optional)

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