Subscription form

Please complete all fields marked with*.

Personal Details

Title*

The data entered into this form is transmitted encrypted to UBS via the internet. Nevertheless, in order to maintain discretion, please do not include any confidential data such as account numbers via this form. UBS does not accept any instructions for business transactions such as the opening of accounts, payment orders, trading orders, revocations of orders or authorizations, blocking of credit cards, changes of address, etc. Please contact the appropriate office or your client advisor for such transactions.

By providing your telephone number and/or e-mail address above you expressly approve UBS contacting you via telephone and/or via unsecured e-mail.

Please note: The use of e-mail can involve substantial risks such as lack of confidentiality, potential manipulation of contents or sender's address, wrong recipient, viruses etc. UBS assumes no responsibility for any loss or damage resulting from the use of e-mails. UBS recommends in particular that you do not send any sensitive information, that you do not include details of the previous message in any reply, and that you enter e-mail addresses manually every time you write an e-mail.

Privacy

UBS AG will use the information you provide to contact you about event content from the UBS Disruptive Technology CEO Summit. For this purpose, your information may be shared with our group companies, agents, partners or service providers (who may be located outside of your home country), such as IT providers. We will not otherwise disclose your information to third parties without your consent unless we are required or requested to do so pursuant to any law, regulation or regulatory order.

If you do not have an account agreement with UBS AG, we intend to use, and provide to our group companies for their use, your information in order to invite you to social, educational or promotional events or to market financial, insurance, banking and related services and products provided or solicited by UBS AG and our group companies (to the extent such products and services are available in your jurisdiction), but we cannot do so without your consent. Please indicate your consent by ticking the box below.

Consent
Confirmation*