First Name:


Middle Name:


Last Name:


Date of Birth:


ECU student ID # (If known):

REQUIRED for counseling options only. 

Below is the link to OSBI website:

It is the applicant's responsibility to obtain the background check - Make sure to check Name Based, Sex Offender, and Mary Rippy Violent Offender on the form. State Fingerprint-based is the only option NOT required.


Upload OBSI Background Form Here