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F-1 students authorized by USCIS to engage in Optional Practical Training (OPT) are required to report any change of name, address, or employment status to the International Student Office within 10-days. Please complete this form to report the changes.
12 Months
17 Months (Required to submit this form every six months)
Employed by one employer (includes freelance work) Start date:
Employed by multiple employers (include freelance work) Start date:
Self-employed (you own a business entity, substantiated by tax and other records)
Not currently employed End date of last job:
Other Please Specify
By submitting this form electronically, you grant permission for your employment information to be reported in the Student and Exchange Visitor Information System (SEVIS) as required by the Student and Exchange Visitor Program, U.S. Department of Homeland Security.