Revised 10/2019
Student ID#: ____________________
Last Name: ___________________________________ Legal First Name: __________________________ Middle Initial: ________
Personal Email Address: ________________________________________ Phone Number: ________________________________
Ove
rview:
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
Thi
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.
On
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.
The
College reserved the right to modify, change, alter or rescind at any time and at its discretion its Changing Biographical Data
policy.
If
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.
Pre
ferred First Name: _____________________________________________
St
udent Signature (required): _________________________________________________________ Date: __________________
Of
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 │ registration@capecod.edu │ www.capecod.edu
