Chemeketa Community College is an equal opportunity/affirmative action employer and educational institution. To request this publication in an
alternative format, please call 503.399.5192.
Office of Enrollment Services, 4000 Lancaster Drive NE, Building 2, Room 200, Salem, OR
Mailing Address: PO Box 14007, Salem, OR 97309-7070
Phone: 503.399.5001 Email: firstname.lastname@example.org
Change of Preferred First Name
To add, update, or remove a preferred name at Chemeketa Community College
1. Complete this form and submit it in person to Enrollment Services with photo ID or via your
MyChemeketa email address to email@example.com
2. The change will be updated within 1-2 business days and should take 24 hours to fully update in the
system, though many changes will be automatic.
3. Please note that this form will only update your preferred first name in the system—which can only
appear in specific places in the Chemeketa system (eLearn, email display name, etc). If you have
legally changed your name, please fill out the form for Change of Information, and provide the required
a. Legal name is required on any official documentation, such as transcripts, enrollment reporting,
tax forms, etc.
b. This will not change your user ID or email address, only the name associated with that email in
your google profile.
Student ID (K#): Date: - -
Legal Current Name in Syst
Last, First, Middle
Street, City, State Zip
Phone Number with Area Code: ___
Preferred First Name: ___________________________________
I am removing my Preferred First Name
If you remove your Preferred First Name, it will default to your legal name in all Chemeketa records
Student Signature: _______________________________________________________________________________________________
I.D. or MyChemeketa
Office Use Only
Processed by: ______________
CURRENT CHEMEKETA EMPLOYEES MUST CHANGE
INFORMATION THROUGH HUMAN RESOURCES