Fayetteville Technical Community College

Curriculum Registration & Records: Student Name Change/Information Update Form

FOR NAME CHANGES ONLY:
The following documents must be submitted to the Registrar's Office to complete your request.

IN PERSON:
Tony Rand Student Center, Room 124
2201 Hull Road, Fayetteville, NC 28303
Days: Monday - Friday
Hours: 8:00AM to 5:00 PM

Email: registrar@faytechcc.edu

*Need to ask a question concerning this form? Send an email with your questions to: registrar@faytechcc.edu. or call 910-678-8476

Personal Information Currently on File @ FTCC
Enter the required personal information listed in your student record with FTCC.

First Name:	A value is required.
Middle Name:
Last Name :	A value is required.
FTCC Email Address:	A value is required. Invalid format.
FTCC Student ID Number:	A value is required. Invalid format.

Information Changes for Your FTCC File
In the remainder of this form, only enter information you would like updated.
New Name
First Name:
Middle Name:
Last Name:
New Address
Street:
City:
County:
Apartment:
State:
Zip Code:	Invalid format.
New Phone Number(s) Include Area Code
Home Phone:	Invalid format.
Cell Phone:	Invalid format.
Work Phone:	Invalid format.

Please make a selection.	By selecting this check-box, I agree that the information on this form is correct and I will complete the submission by physically bringing the documentation to the Curriculum Registration & Records Office on the Fayetteville Campus OR by scanning the documentation and emailing it to registrar@faytechcc.edu.