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HELP DESK

Multifactor Authentication (MFA) Assistance Request Form

Requests are answered in the order received, please be patient during open registration periods.

Please note that we must have either a valid cell phone number or personal email address provided below in order to assist you with the MFA login process. Once your cell or personal email are updated in our records you will be able to use one or both of them for validation during login. Once you have logged in please make sure to review and update your security questions and answers for future ease of access.

* = Required fields

Lakeland ID:

Full Name:*

Date of Birth:*

Last Four Digits of your Social Security Number:*

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Current Contact Information

Street:*

City:*

State:*

Zip:*

Personal Email Address:*

Home Phone:*

Cell Phone:

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Contact Information in our system (only provide if different then current)

Street1:

City1:

State1:

Zip1:

Personal eMail Address1

Home Phone1:

Cell Phone1:

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