Legal Name Consent Form

The name pin you will receive with your white coat must contain your legal name. Please complete and submit your legal name information below by July 25, 2008 to allow us to produce an appropriate name tag. Under no circumstances may you use a nickname or a name which has not been legally sanctioned.

Please indicate the LEGAL name under which you will be registered and the form of it you use. We know from the past that some of you will routinely use suffixes such as Jr. or III, have changed your names, married and choosen to use a different name from your admission application, or perhaps use a variant of the usual form (i.e. J. William Smith instead of John W. Smith).