Name
(Required)
First
Last
Email
(Required)
Student Number
(Required)
Campus
(Required)
Canterbury
Epsom
Farnham
Rochester
Which Identity Community would you like to join? Select all that apply
(Required)
BAME (Black, Asian and Minority Ethnicities) Students
Disabled Students
LGBTQ+ Students
Women Students
We are looking for Identity Community leaders, would you be interested in the role?
(Required)
Yes
No