Student Rep Leaf Submission Form
Thank you for taking part in the Rep Leaf Scheme. This is for you to log what you have done as a Rep, and for you to be rewarded for it. You will receive John Smith Book tokens on achieving each Leaf (bronze, silver and gold). You will need to complete three achievements. We would like to use your quotes and photos to celebrate Rep Scheme successes - please indicate on the form if this is ok. If you have any questions get in touch with Ellie at or find out more at
Name *
Your answer
Rep Position *
Are you happy for us to use your photos and to quote you in publicity to promote the Rep Scheme? (e.g. in the Rep Newslettter, Union Newsletter, on the Union website and in Rep Publicity?) *
Which tier of the leaf scheme are you submitting evidence for? *
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