Deregister

Customer panel deregistration

To leave the Customer Panel fill in the deregistration details below and click 'Submit'.

You will be removed from the Customer Panel and will no longer receive any communication about the Panel from the West Brom.

Email address:

First name:

Surname:

Reason for leaving:

*Indicates a required field.

By clicking submit you are requesting to be removed from the Customer Panel.

FAO Customer Research Manager 2 Providence Place West Bromwich B70 8AF

Telephone: 0345 241 3784 Fax: 0121 500 5961