history

CAREER PLANNING ORIENTATION FORMDATE:
CONTACT INFORMATION
NAME:Student ID:PHONE:CELL PHONE:ADDRESS:CITY:STATE:ZIP:PERSONAL EMAIL:
BEST FORM OF COMMUNICATION:

EMAIL

PHONE
Best time/s to be reached:
 Day
 Afternoon
 Night
GRAD DATE:
MONTH:YEAR:ENROLLMENT DATE:
MONTH:YEAR:
CAMPUS
 Virginia Beach – ECPI
 Newport News – ECPI
 Raleigh
 Northern Virginia
 Virginia Beach – MCI
 Newport News – MCI
 Greensboro
 Charlotte
 Concord
 Greenville
 Columbia
 Charleston
 Richmond S/W – MCI
 Online – ECPI
 Innsbrook/Glen Allen
 Richmond/MoorefieldPROGRAM
 Associate  Bachelor
 Masters

Network Security

Software Development

Masters/Information Systems

Healthcare IT

Business Administration

Mechatronics

Cloud Computing

Accounting Administration

Biomedical Technology

Simulation & Game Programming

Criminal Justice

Electronics Engineering
Technology

Database Programming

Homeland Security

Maritime Technology

Web Development

CERTIFICATIONS / AWARDS
Please list any relevant professional certifications that you currently hold: ________________Please list any awards that you received: CITIZENSHIP
Are you a United States Citizen?  YES  NO If no, are you able to work in the U.S.?  YES  NO
In addition to English, what other languages do you speak?  English Only  Others:
DRIVING RECORD

0 traffic violations in 3 years

1-3 traffic violations in 3 years

4 or more traffic violations in 3 yearsCAREER PROFILE AND EXPECTATIONS
Are you willing to relocate for an opportunity?  YES …