Original – Registrar’s Office
Yellow copy – Student
RO-020/Revised: TL-09/01/2020
IMPORTANT: Submit this form to the Registrar’s Office, room C-107.
Original – Registrar’s Office
Yellow copy – Student
Registrar's Office use only
LaGuardia Community College - Office of the Registrar
Preferred Name Request
CUNYfirst EMPL ID#
Last Name
First Name
Middle Name/Initial
G
R
A
DU
A
T
IO
N
YEAR (Expected):
I request that the following name be recorded as my Preferred Name in the Student System:
Preferred Name*:
First Name
Middle Name/Initial
*Please note that only first and/or middle names may be requested. Please select names that you
would be comfortable using in the classroom and other CUNY settings
While CUNY recognizes the importance that a change of name might have to students during their time with the
University, a preferred name is not a legal name, but is generally used to change how others refer to you. For this
purpose, students may identify a preferred name to be recorded in the student system. No documentation is
required to have a preferred name recorded. Documents and records that may display a preferred name include,
among other things, course rosters, student identification cards, student email addresses and other documents
issued by the University. A preferred name will not be reflected on, among other things, a student’s official
academic record, diploma, or transcript. To change the name that is displayed/reflected on official academic
record, diploma, or transcript students must follow the instructions on the Personal Data Change Request form
available in the Registrar’s Office. Official and legal name changes require specific documentation outlined on
that form.
P
lease initial here to indicate you have read and understand the paragraph above.
Student’s Signature:
Date:
Signature from Pick-up:
Date:
PLEASE PRINT CLEARLY
CURRENT LEGAL NAME
Processed by:
Date:
