Chosen Name Authorization Form

Laramie County Community College recognizes and supports individuals who may want to use a different first name other than their legal first name while attending the College. Current students who would like the first name they use at LCCC to match their preferred/chosen name and/or their gender identity may complete this form. Additionally, a chosen name is limited to one word or name; it may be a completely different first name, or a shortened version of a student's legal first name. All chosen name requests are subject to institutional review and approval.


Opting to use a chosen name while at LCCC is not the same as a legal name change; however, your chosen name will be changed on all of the following: Student ID card (additional cost may apply for a new card), LCCC student profile including, but not limited to, login credentials, myLCCC, Canvas, LCCC email, Navigate; and class and grade rosters; other LCCC systems.


By submitting this form, the student acknowledges that LCCC employees may have access to view both legal and chosen name within FERPA guidelines as it pertains to their position responsibilities at the College. This authorizes LCCC to make the changes to the student information as listed above. Please allow 14 business days for processing. Students will be contacted when the chosen name change is complete. Students may rescind this authorization in writing with the Office of the Registrar at any time.

Please enter your 7-digit LCCC ID number.

Your LCCC email is your firstnamelastname@student.lccc.wy.edu.

Please list your chosen/preferred first name. Your last name must remain your legal last name.

Choose your preferred pronouns.

Select
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