OPT Participants: STEM Extension

International
Program and Services

OPT Participants: STEM Extension

By submitting this form, you are affirming that:

-You are currently employed or will be employed with the employer specified below when the STEM extension takes effect.

-You understand that each employer while on the STEM extension must be enrolled in the E-Verify system and the work must be directly related to your degree.

-You understand that you are required by law to confirm your STEM employment participation to the Office of International Programs and Services every six months using this form, whether or not there have been any changes.

-You have not been previously granted a STEM extension.

CLICK HERE FOR THE OPT STEM EXTENSION GUIDE

First Name

Last Name

Pacific ID Number

SEVIS Number

End Date of Current OPT

Phone Number

Have you previously been authorized for the STEM Extension by USCIS?

YesNo

US Residential Address

Street Address

City

State

Zip Code

Employer Information

Employer (company)

Employer E-Verify Number

Street address

City

State

Zip Code

Supervisor Name

Supervisor's Title

Supervisor's phone number

Supervisor's email

Employment Start Date

First day after current OPT ends

Employer EIN#

Employment Type

Full TimePart Time

Weekly Average of Hours Worked

I work more than 20 hours/week in this position (average)I work fewer than 20 hours/week (average)As a reminder, to 'count' as employment on STEM OPT, you must work for a combined 20 hours/week (weekly average). You can hold multiple jobs that combine for 20 hours/week, as long as all jobs are directly related to your studies and all are with E-Verify companies. If you are not working 20 hours/week, you will accrue unemployment time with USCIS. You are limited to 120 days of unemployment during your year of post-completion OPT and STEM extension combined.

Job Title

Explain how employment is related to your major

In 2-3 sentences, explain how this job is directly related to your degree program. Your response will be reported to USCIS 'as is'; it will not be edited or reviewed for accuracy. OIA advisers cannot confirm that your job is related to your studies; it is your responsibility to clarify the degree relevancy. Having a job directly related to your degree is a requirement of STEM OPT and reporting this relevancy is necessary for STEM OPT employment. (Max 250 characters). Do not include any special characters (e.g. [ ( < * & @)

Completed Form I-765

Completed Form I-983

Copy of degree earned

Copy of current EAD card (front and back)

Contact Information