Fayetteville Technical Community College

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

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.
FOR NAME CHANGES ONLY: The following documents must be submitted to the Registrar's Office to complete your request. Copy of your picture ID Copy of your signed Social Security Card with your new name 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
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.