Course Rep Application Form It’s great that you want to sign up to be a course rep at CU London. The information you provide below is really important to us to ensure that we are able to contact you. We share your name, course title and email address with the Student Registry team at CU London. This allows them to send you invitations to Student Voice Forums each teaching block. All other data remains with CUSU CU London. We will contact you in relation to activities relevant to your role and any opportunities we think might interest you as reps such as career development or dedicated rep social activities Forename: Surname: Student Email Address (ending in @coventry.ac.uk or @cusc.coventry.ac.uk) Student ID: Rep Type: Course Rep Senior Course Rep My Picture Upload your picture here to allow your fellow students to see who their rep is. We will use this image on a dedicated rep webpage at cusu.org/cuscarborough and on materials around the Campus. Select image to upload: Course Name Select Course TitleApplied BiosciencesBiological & Chemical SciencesBusiness & LawBusiness Management & LeadershipComputer ScienceCounselling: Integrative Theory & PracticeCyber SecurityEarly Childhood Development & LearningElectro-Mechanical EngineeringFinancial ServicesFoundation BusinessFoundation EngineeringHealth & Social CareLaw & PracticeMarketing & Public RelationsPolicingProfessional AccountingPrimary Education & Teaching StudiesPublic Health & Community Studies Level of Study Select Level of StudyYear 1Year 2Year 3AccessFoundationPart TimeWeekendTop up Block Start Date Select Block Start DateBlock 1Block 2Block 3Block 4Block 5Block 6 In order to become a course rep you are required to have two nominating students from the CU London community supporting your application. Please insert their name and student ID number in the following boxes. Nominating Student Name 1 Nominating Student ID 1 Nominating Student Name 2 Nominating Student ID 2 Age 18-21 22-25 26-35 36-49 50 and over Gender E.g. Male/Female/Non-binary etc Ethnicity By submitting this form you confirm that you have read the Rep Code of Conduct and agree to abide by the content within.