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OPtional Practical training Employer Information Form

According to U.S. Federal regulations pertaining to F1 students on Optional Practical Training, F-1 students are responsible and required to report the following information during the entire period of authorized OPT (including OPT volunteer/unpaid work):

Current U.S. address
Name of OPT Employer
Address of OPT Employer

If you are currently on approved OPT, please complete and submit the form below each time you have a new employer.

Student Information

First name:

Last name:

E-mail:

CSUFID (no dash):

Address:

City:

Zip:

State:

WAC Number:

Phone:

OPT EAD Start Date:
(MM/DD/YYYY)

OPT End Date:
(MM/DD/YYYY)

Please select the option that applies to you:

I have applied for OPT. My OPT period has already begun. I am currently seeking OPT employment.

I am on approved OPT and am currently working.

I have been approved for OPT, but have decided to return to my home country.

I was on approved OPT, but I have changed my status to H1B.

I was on approved OPT, but I have changed my status to Permanent Residency.

Other: (please specify in the remark box)

Remarks:

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