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Request to Add Preferred Name on CIT Roll Book

This form is to be completed by students who wish to have a preferred name listed on CIT class roll books.

Fields marked with * are required.

CIT Number*
Legal First Name*
Legal Last Name*
Preferred First Name*
Email Address*

Mandatory tick box for the following statements:

I understand only my teachers will know my preferred first name.*
I understand my Legal Name will appear on all other CIT documents, certificates and communication.*
Examples: CITCard, timetable, invoice, statements, certificates, testamurs, competency cards and email communication from CIT.
I understand my preferred first name can only be changed once per year .*
I understand the request to have a preferred first name may not be successful if the name I have chosen is found to be derogatory or defamatory in anyway.*

By ticking all the above boxes you agree to CIT staff entering the Preferred Name you have listed above on to the Student Information Management System.

All personal information provided will be handled confidentially in accordance with the Information Privacy Act 2014 (ACT).