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Legal Name
*
Preferred Name*
*
Official Job Title
*
Department Name
*
Department Site Name
*
Department Address
*
Phone Number
*
Email
*
Pronouns (optional)
She, Her, Hers
He, Him, His
They, Them, Theirs
Quantity
250 cards ($15)
500 cards ($20)
1,000 cards ($30)
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*
Ship Finished Cards To
*
Signature and Date
*
I certify that this is the official District title for the employee listed on the form.
Authorization by:
*
V.P. of Administrative Services or Appropriate Manager
Cabinet Member
*
<strong>*Approval of Preferred Name Use: </strong>Preferred names that are different than legal names, i.e. "Bill" for William would not need Cabinet approval.
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