Preferred Name Request Form

Preferred Name Request Form
This form is to request a preferred name be added to a student's record. The legal name will not be changed until a student completes a Student Information Correction Request and provides proper documentation. Valid photo ID is required.

Please note that our current software has limitations and will still display your legal name in your WolfWeb student portal and on some of our correspondences to you. Some class rosters may still show legal name only.
BMCC ID
Name

Legal First NameLegal Last Name
MI
Preferred Name Used
Date of Birth

MonthDayYear
Date
Phone
Format: (000) 000-0000.
Email
example@example.com
Note: Your current inbox will be deleted and a new one created. This action cannot be reversed. Please save any emails you need before submitting this request.
- By completing this form, I am requesting my preferred name be added as selected below.
- I understand that my name on my BMCC student record must match my legal name and that the preferred name requested above does not change my legal name in my student record.
Please choose at least one option for the list below:
Upload your Valid Photo ID. Example: Valid Drivers License (Required)

Cancelof
Student Signature
Date

MonthDayYear
Date
For questions, please contact Enrollment Services at StudentRecords@bluecc.edu or call (541)278-5759.

Blue Mountain Community College is an equal opportunity educator and employer.
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