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* 1. Your Name

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* 2. Your K Number/ KU Number

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* 3. Your Course (if you are staff just state 'Staff Member')

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* 6. Your E-Mail Address

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* 7. Name of the Course Rep you are nominating

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* 8. Are they a Course Rep or Senior Course Rep?

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* 9. K Number of the Course Rep you are nominating (if known)

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* 10. How do you know the Course Rep you are nominating?

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* 11. Why do you think this student should be awarded "Course Rep of the Year"?

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* 12. How has this Rep gone about gathering feedback from peers on course(s)/programme(s) they represent?

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* 13. What impact has their involvement as a Course Rep had on the course/programme they represent? Have they undertaken any innovative activities to enhance the student experience on your course or at Kingston University?

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* 14. In what ways have they fed back outcomes of meetings to the students they represent?

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* 15. Is there anything else you would like to tell us about why you think they should be considered for this award?  Alternatively you can email academicimpactawards@kingston.ac.uk with supporting evidence

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