Diversity and Inclusion Office for International Students and Scholars STEM OPT Reporting – Change in Employment Use this form if you have a pending or approved STEM OPT application and have changed jobs. OISS: STEM OPT Reporting - Change in Employment Important: you cannot report this information via the SEVP Portal. To add an employer to your record, you must submit this form. After you submit this form, OISS will mail you an updated I-20 within two weeks. For more information please refer to the SEVP Portal Student User Guide here. Is your NEW employer enrolled in E-Verify? * Yes No Is your 24-month STEM OPT Application Pending or Approved? * My application is PENDING My application is APPROVED Before you continue with this form, you must have scanned copies of the following 3 documents ready to upload: STEM OPT I-797 receipt Signed I-983 form for new employer Signed I-765 form for the new employer Before you continue with this form, you must have scanned copies of the following 3 documents ready to upload: STEM OPT EAD card Signed I-983 form for new employer Completed Evaluation on Student Progress section on page 5 of the I-983 form for your previous employment. The evaluation form is required, even if you have not worked with your employer for 12 months. An F-1 student interested in participating in the STEM OPT extension must select a prospective employer that is enrolled in the USCIS E-Verify program. This means that you cannot work for an employer unless they are enrolled in E-Verify. If you have questions, please contact your International Advisor. Your Contact Information Family/Last Name * Given/First Name * WashU Student ID * Your six digit ID, not your WUSTL Key. Optional - SEVIS ID (found on your I-20, N followed by several digits) Date of Birth * Email Address * Cell Phone Number * Current Residential Address * Current Residential Address Street Number and Name Street Number and Name Apartment Number, if any Apartment Number, if any City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Previous Employer Information Previous Employer Name * Previous Employer Address * Previous Employer Address Street Number and Name Street Number and Name Address Line 2, if any Address Line 2, if any City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Last Day Worked for This Employer * STEM OPT File Upload Instructions Before you continue with this form, you must have scanned copies of the following 3 documents ready to upload: STEM OPT I-797 receipt Signed I-983 form for new employer Signed I-765 form for the new employer Before you continue with this form, you must have scanned copies of the following 3 documents ready to upload: STEM OPT EAD card Signed I-983 form for new employer Completed Evaluation on Student Progress section on page 5 of the I-983 form for your previous employment. The evaluation form is required, even if you have not worked with your employer for 12 months. STEM OPT File Upload * Drop a file here or click to upload Choose File Maximum upload size: 33.55MB Review and Submit for STEM OPT PLEASE REVIEW your form for complete accuracy BEFORE SUBMITTING. Submit