Student Identity Accommodation Request

Please complete this form if you wish to make any changes to a student identity. Accommodations can be requested by students or parents/guardians. Only parents, guardians, or educational decision makers for minor students can approve a request for accommodation. Students who are 18, who are emancipated or who are not living with their parent or guardian can approve their own requests. This information will be used as part of Ames CSD’s official student records.

Ames CSD Identity Accommodation Request

I/We are requesting the following identity accommodation:(Required)

Legal Identity Change (Requires Court Order)

Preferred Identity Accommodation

Nickname

Person Completing This Form:(Required)

Relationship to Student:(Required)

School Building Student Attends:(Required)

Legal Identity Changes

Legal identity changes require a court order under Iowa Law. To finalize a legal identity change, please provide a copy of the court order to the district registrar by emailing registrar@ames.k12.ia.us or by dropping off a copy in-person at Ames District Offices, 2005 24th Street.

Effective Date for Legal Identity Change(Required)

Preferred Identity Accommodation

Preferred identity accommodation can be initiated using this form. The student’s preferred identity information will appear in most district systems and will also be listed on documents such as class rosters, schedules, and media publications. The student’s preferred identity information will be widely available to teachers and peers.

Effective Date for Preferred Identity Accommodation:(Required)

Student's Full LEGAL Name & Gender:(Required)

Student's ID Number (6-Digits):(Required)

What grade is the student in?(Required)

Student's Preferred First Name:(Required)

Student's Preferred Last Name:(Required)

Student's Preferred Gender Identity:(Required)

Male

Female

Non-Binary

Student's Preferred Pronouns:(Required)

Other Accommodations (Be as specific as possible):

Nickname

Students who wish to be called by a nickname will have that nickname indicated in Infinite Campus. This can be updated each year during registration or at any time during the school year. Staff will refer to students based upon the name and or nickname as indicated in Infinite Campus. (i.e. Sam rather than Samuel or Addy rather than Adeline)

Student's Full Name:(Required)

Student ID Number:(Required)

What grade is the student in?(Required)

Student's Nickname:(Required)

Authorization

By typing my name below I affirm that I am the party legally authorized to submit this request.(Required)

This field is for validation purposes and should be left unchanged.

Student Identity Accommodation Request

Ames CSD Identity Accommodation Request

Legal Identity Changes

Preferred Identity Accommodation

Nickname

Authorization

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