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Current location: Coventry

Course Rep Application Form

It’s great that you want to sign up to be a course rep at Coventry University 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 Coventry University London. This allows them to send you invitations to Student Voice Forums three times a year. All other data remains with CUSU Coventry University 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



Email Address:


Student ID:


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 and on materials around the lounge. Select image to upload:

Rep Type:

I want to be a Course Rep

I want to be a Senior Course Rep

I want to be a Service Rep


If you selected Service Rep please choose from the three options which service you would most like to work with.
Library Service Rep
IT Service Rep
Campus Experience Rep

Level of Study:

Course Title:

Mode of Study

Nominating Student Name 1


Nominating Student ID 1


Nominating Student Name 2


Nominating Student ID 2


Nominating Student Name 3


Nominating Student ID 3



50 and over


E.g. Male/Female/Non-binary etc.


Ethnic Origin


By submitting this form you confirm that you have read the Rep Code of Conduct and agree to abide by the content within.

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