PO Box 309 • Jamestown, NC 27282 • 336-334-4822 or 336-454-1126 • TTY 336-841-2158
Preferred Name Form
Current Information
Student ID #: _____________________________
Legal Last Name: _________________________ Legal First Name: ______________________________
Phone Number: ___________________________
Preferred Name
First Name: ____________________ Middle Name: _________________ Pronouns: _______________
Do you want the first two letters of your college user ID updated to reflect preferred name?
Yes, please change my user ID. No, I wish to continue using my current user ID.
GTCC allows any student to request a preferred name that will appear on campus technologies that do not
require legal name in place of the student’s legal name. Please allow five to ten business days for changes
to appear.
Note that currently GTCC is unable to display preferred name on WebAdvisor related technologies including
student access screens, instructor class rosters, and grade rosters. Instructors will be notified by email of the
preferred name.
Directions: Submit to the College Registrar’s office located in Sears Applied Technologies Building, first
floor, Enrollment Services area or scan and submit directly to . Recommendation is to
submit this form 2 weeks prior to the start of the Semester.
Please read and sign: Please change records to reflect my preferred name. I understand that some official
records, such as the college transcript and financial aid, must continue to use my legal name.
Student Signature (Legal name): _________________________________________ Date: __________
Registrar Information
Name: __________________________ Signature: __________________________ Date: __________
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