FXU Student Council Nomination Form 2010-11 - FXU Students Union

FXU Student Council Nomination Form 2010-11
I would like to nominate myself to be an FXU Student Council member as one of the
representative roles stated below and on the conditions of FXU Student Council
membership. (Please tick this statement if you agree). See conditions via this link.
Which Rep Role would you like to nominate yourself for the FXU Student Council?
Rep Role Representative of Please tick as
appropriate
Academic Rep UCF Art Foundation
Academic Rep UCF Design
Academic Rep UCF Media
Academic Rep UCF Performance
Academic Rep UCF Art
Academic Rep UCF Postgraduate UCF
Academic Rep UECC English & History
Academic Rep UECC Camborne School of Mines
Academic Rep UECC Law & Politics
Academic Rep UECC Biosciences & Geography
Academic Rep UECC Postgraduate UECC
Halls Rep Glasney Village (A-J blocks)
Halls Rep Glasney Village (K-O blocks)
Halls Rep Glasney Village (View)
Halls Rep Tuke House
International Students Rep UCF International Students UCF
International Students UECC International Students UECC
Open Position All students
Please complete the following with your details
Name:
Email address (if selected, the email address you provide will be publicised to students as your
contact email address so please make sure you provide an email address you are happy about
publicising and being contacted on):
Telephone:
University:
Course:
Foundation/Undergrad/Postgrad:
1 st /2 nd /3 rd /4 th year if applicable:
Halls including Block if applicable:
Please hand in your completed Nomination form along with the Equalities Monitoring
form on the next page to either FXU front offices at Woodlane or Tremough or send to
Janice at repcoordinator@fxu.org.uk
Deadline for nominations is 12 noon Friday 29 October 2010.

Falmouth & Exeter
Students’ Union
FXU Student Council 2010-11
Equalities Monitoring Form
This form will not have any affect being a candidate for FXU Student Council and will
be separated from your nomination form once handed in/emailed to FXU and
therefore will be anonymous. Any information given will be treated sensitively.
As FXU actively commit to equal opportunities, the information you provide in this
form will help to monitor this.
Please circle the information below that relates to you currently. Many thanks.
Study Information
1. Are you a full-time or part-time student? Full-time/ Part-time
2. Where is your study based?
About You
Tremough Woodlane Distance-learning
3. Are you an international student? Yes/ No
4. Which age-group are you in?
18-21 years 22-24 years
25-29 years 30-39 years
40-49 years 50-59 years
60-69 years 70 years and over
Prefer not to answer
5. What is your gender?
Male Female
Transgender Prefer not to answer

6. What is your sexuality?
Heterosexual Lesbian or Gay
Bisexual Transsexual
Prefer not to answer
7. What is your ethnic background?
White White- British
White- Irish Irish Traveller
Other White background Cornish
Black or Black British – Caribbean Black or Black British – African
Other Black background Asian or Asian British – Indian
Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi
Chinese Other Asian background
Mixed – White and Black Caribbean Mixed – White and Black African
Mixed – White and Asian Other Mixed background
Other Ethnic background Not known
Prefer not to answer
8. What is your religion/belief?
Christian Hindu
Buddhist Muslim
Sikh Jewish
Humanist No belief
Other Prefer not to answer
Thank you so much for filling out this form as it really does help FXU to be as
representative as possible for all students.
Please hand the form into the FXU office/include in email with your nomination form
(and it will be kept separate as stated at the top of the form).