STEM OPT Employer Change

Who should use this form?: Students currently on STEM OPT that need to report a change in employer.

Identification Information

Last Name

First Name

SEVIS ID

Birthdate

Current Email Address

STEM Extention Application Status *

PENDING - My STEM Extension Application is still pending.
APPROVED - My STEM Extension Application has been approved.

Previous Employer *

I am not leaving my previously reported employer and am adding a second employer.
I have left my previous employment and am reporting new employment.
I have left my previous employment and am not currently reporting new employment

Previous OPT Employers *

Please list all previous employment you had while on OPT.

No Employers Listed

Click on the "Add Employer" button above to add an employer.

New Employer

New Employer Name

New Employer Identification Number (EIN)

New E-Verify Number)

Employment Start Date

Job Title

Number of Hours Worked per Week Must be a paid position and at least 20 hours per week at each position.

Employment Address

Supervisor Last Name

Supervisor First Name

Supervisor Email

Supervisor Phone

Copy of Fully Completed I-983

Choose file(s)

Files must be smaller than 2MB and must be one of the following file types: gif, jpg, jpeg, png, pdf
To select multiple files use Control-Click (Windows)/Command-Click (Mac) or Shift-Click when selecting files.

Copy of Offfer Letter

Choose file(s)

OPT 24 Month STEM Extension Reporting Acknowledgement *

Please review the STEM Reporting Requirements here: STEM Reporting Requirements

I have reviewed the STEM Reporting Requirements and acknowledge that I understand my reporting requirements.

Information Certification *

I certify that, to the best of my knowledge, the above information is correct and I understand that inaccurate or invalid information could result the termination of my I-20 and my F-1 status.

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