Revised 10/2019
Student ID#: ____________________
Last Name: ___________________________________ Legal First Name: __________________________ Middle Initial: ________
Personal Email Address: ________________________________________ Phone Number: ________________________________
The College recognizes that some students may prefer to use a first name other than their legal name to identify themselves. As
long as the use of a preferred first name is not for an improper purpose, the College acknowledges that a preferred first name can
and should be used where possible in the course of the College business and education. Students may use a preferred first name
wherever a legal name is not required on internal documents, communications, systems, and web portals. Examples include, but
are not limited to:
Student identification cards
Email and calendar entries
Class rosters and advisor lists
Learning Management Systems
Awards and registrations
s form does not change a student’s legal name. A student’s legal name shall be used on all College documents, systems and
communication external to the College and/or where a legal name is required. Examples include, but are not limited to:
Finance records
Student accounts records
Student personally identifiable information
Student directory information
Payroll records
Health records
Official transcripts federal immigration documents
Interaction with government agencies
To change your legal name on all College records, a court order or other acceptable legal documentation is required.
ce a preferred first name has been requested, that name will be used by the College as detailed above until the student
withdraws his/her request for the use of a preferred name.
College reserved the right to modify, change, alter or rescind at any time and at its discretion its Changing Biographical Data
the use of a preferred first name is for an improper purpose, including but limited to misrepresentation or attempting to avoid a
legal obligation, a student may be subject to disciplinary action, up to and including expulsion. This document does not form a
legally binding or enforceable contract.
ferred First Name: _____________________________________________
udent Signature (required): _________________________________________________________ Date: __________________
fice of the Registrar Use Only:
Date Received: __________________Date Entered: _________________________ Initials: __________________
Office of the Registrar PREFERRED FIRST NAME FORM
2240 Iyannough Road West Barnstable, MA 02668
774.330.4711 Fax: 508.375.4084