OPT Employment Form

This form is to be used by U-M students who are currently on Post Completion OPT and are reporting new employment. If you are on the 24 Month STEM Extension, please report your employment here: STEM Change Employer

**YOUR EMPLOYMENT DETAILS WILL BE REVIEWED AND UPDATED IN SEVIS. HOWEVER, YOU WILL NOT RECEIVE A CONFIRMATION EMAIL UPON SUBMISSION OF YOUR EMPLOYMENT INFORMATION.**

Tags:

F-1 Students

Personal Information

Last Name: *

First Name: *

UMID: *

SEVIS ID: *

Current Email: *

Employment History

First Job or Not *

This is my first job on Post Completion OPT.

I had a previous job while on Post Completion OPT and now I have a new job.

I currently have a job while on Post Completion OPT and now I am adding a second concurrent job

I had a previous job while on Post Completion OPT and now I am unemployed.

I have never had a job while on Post Completion OPT.

I am updating my current job information.

Previous Employment

Previous Employer/Company Name: *

Previous Employment End Date *

Month

Day

Year

New Employment Information

Employer/Company Name: *

Employment Start Date: *

Month

Day

Year

Job Title: *

Full Time / Part Time *

Full Time: 20 hours or more per week

Part Time: less than 20 hours per week

Average hours per week: *

Employment Address:

Street: *

Suite:

City: *

State: *

Zip Code: *

In 1-2 sentences please explain the relationship between your job duties and your major field of study. *

Comments

Certify *

I certify I have read the OPT information about Post Completion OPT available at the IC web site, and the information I have provided is, to the best of my knowledge, accurate. I understand that I (and any F-2 dependents) must have U-M approved health insurance coverage for the duration of my F-1 status. I understand I must report address changes, current (U.S.) or permanent (outside U.S.), as well as phone number and email changes, through Wolverine Access within 10 days of any change.

	1500 Student Activities Building 515 E. Jefferson Street Ann Arbor, MI 48109-1316
	734.764.9310
	icenter@umich.edu

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