Office of International Student Programs & Services, University of Arizona

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OPT Reporting Form for University of Arizona Students All students on OPT must fill out this form Use this form to report a new employer, change of employer, termination of employment, change of immigration status, or completion of OPT prior to the end date on EAD and departure from U.S. Please complete the following information and click the "submit" button when finished.

Full Name (Last, First):

UA Student ID:

SEVIS ID: Your SEVIS ID begins with N and is found on the upper right corner of your Form I-20

E-mail Address:

Employment Authorization Document (EAD)

Start Date on EAD (month/day/year):

End Date on EAD (month/day/year):

Please submit a clear photocopy of your EAD to ISPS. Please write your UA Student ID on the photocopy.

Select delivery method:

Confirm the street address where you currently reside (no P.O. Box):

Street:

Apartment:

City:

State:

Zip Code:

Employment Information:

Select One:
	I am not currently employed and am actively seeking employment.
	I am currently employed.
	I am employed as an unpaid volunteer.*

If you are volunteering on the UA campus, please ask your supervisor to contact UA Human Resources regarding the Volunteer Agreement and Release.*

If you have multiple employers, please submit additional OPT Reporting Form(s) for each employer. For example, if you are a student with a performing arts degree and have multiple short-term jobs (gigs), you will need to submit an OPT Reporting Form for every gig.

Use this section to report a new employer:

Please select:	Primary Employer Secondary Employer

Employer/Business Name:

Supervisor's First and Last Name:

Supervisor's E-mail Address:

Worksite Street Address:

City:

State:

Zip Code:

Employment Start Date (month/day/year):

Employment End Date (month/day/year) (if applicable):

Use this section to report termination of employment:

Name of Previous Employer:

End Date of Previous Employment:

Change of Immigration Status:

I have changed my status from F1 to:

Please submit a photocopy of proof of your new status to ISPS. Select delivery method:

Returned Home/Left the United States:

I have permanently left the U.S. and have no intention of completing my OPT. I departed the U.S. on (enter date month/day/year):

If you need to clarify any of the above information, please use this space to explain discrepencies: Please limit your remarks to 4 lines.

If you have lengthier comments or any OPT-related questions, please e-mail OPTinfo@email.arizona.edu .

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Office of International Student Programs & Services
915 North Tyndall Avenue P.O. Box 210441 Tucson, Arizona 85721 United States of America
Tel: 1.520.621.4627 Fax: 1.520.621.4069 | Office Hours: 8:00-12:00 1:00-5:00 Monday-Friday