Notice of Name Change
(And Related Student Records)
This form is used to request a name change in FKCC student records. You must provide a copy of proof of the
name change with documentation such as a driver’s license, marraige certificate, divorce decree or related
court-approved document.
Once you submit this form with required documentation, your name should be updated within 48 hours. Your
FKCC email adrees, portal login, D2L login, and D2L email address will change to your correctly-spelled name.
You will receive an email confirmation when the process is complete.
Student ID or Last Four Digits of SSN
Date of Request
Current Name in FKCC Records
New Name
Current Phone Number in FKCC Records
New Phone Number
Current External Email Address
New External Email Address
Current US Mail Address
New US Mail Address
Reason for Name Change
Date of Change
Are you currently enrolled in an online course?
Yes No
Signature
This form and supporting documentation may be faxed to 305-292-5163 or scanned and emailed from your
fkcc.edu address to admissions@fkcc.edu. It is important to use your FKCC email account for security purposes.
ES Staff Only:
Edit name in SPAIDEN (first screen only)
Change name on E-file account
Create a spice works to edit email, portal, and D2L login
Initial Date
click to sign
signature
click to edit
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