Elizabeth City State University

Please take a moment to tell us about yourself. This information you provide will be treated confidentially and will only be used by Elizabeth City State University.

If you have already created a Viking Portal account, do not create a second account ... it is very important that you continue to use the same account throughout your relationship with ECSU. If you have forgotten your password, you can reset via the Viking Portal.

Personal Information

First Name (given name): (required) *

Middle Name (if applicable):

Last Name: (required) *

Preferred First Name:

Date of Birth: (required) *

Email Address: (required) *

This email is already being used.

Prospect Information

Year of Entry into ECSU: (required) *

Student Type:

Where did you go to high school? (required) *

Where did you go to college? (required) *

Primary Contact Information

Country: (required) *

Address Line 1: (required) *

Address Line 2:

City: (required) *

State: (required) *

Zip Code: (required) *

Address Line 1: (required) *

Address Line 2:

City:

Province/State:

Zip/Postal Code:

Permanent Phone Number:

Confirmation