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Personal Information
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SEVIS ID
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NUID
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Street Address
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Zip Code
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Current OPT Employment Information
Employer Name
*
What date did you start this job?
*
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Employer Street Address
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Employer City
*
Employer State
*
Employer Zip Code
*
Number of hours worked per week
*
How is this position related to your major
Previous OPT Employment Information
Please fill this section out if you have left a job or are employed by more than one employer.
Employer Name
What date did you start that job?
Month
Month
Jan
Feb
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Apr
May
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Jul
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Dec
Day
Day
1
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Year
Year
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2022
2023
What date did you end that job?
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
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28
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30
31
Year
Year
2018
2019
2020
2021
2022
2023
Employer address(street, city, state, zip code)
Number of hours worked per week
How was this position related to your major?
Form I-983 for OPT STEM
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Additional Form I-983 for OPT STEM
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