Register for information If you are a state school or college in the West Midlands please use this form to register for information, advise the Outreach Team of additons/changes to your contact details, or to advise us that a member of staff has been replaced. Outreach activities are available to learners at state schools in the West Midlands. If you are from a school or college in the West Midlands area and would like to keep up to date with the activities we offer, then please complete the information below. If you are from an independent school and/or outside the West Midlands you should contact the University's Recruitment Team - please have a look at their information. I am a new contactI am replacing someone If you are replacing someone, please tell us who you are replacing Title Mr Mrs Miss Ms Other Other title Free text for alternative title Name First Last Email Job Title Organisation name in full Type of organisation Secondary school/college/academyFE CollegeSixth Form CollegeOther type of organisation If other, please specify Free text for other type of organisation Address Address Line 1 Address Line 2 City County / State / Province Postcode / Zip Code Country Phone Additional comments Submit The data collected on this form will be used to update contact information held in the Outreach Team and to keep you informed of Outreach activities.