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Optional Practical Training Reporting

This form is to be used by F-1 students who are currently participating in OPT. All information is required unless otherwise specified. Please type N/A in the fields that do not apply to you.

Contact Information

Last/Family Name
First/Given Name
SIUE ID (800-XXX-XXX)
E-mail Address
Telephone

Current Residential Address
Street
City
State
Zip Code

Current Mailing Address
Street
City
State
Zip Code

Information Required by USCIS

If you work for more than one employer, you must list the contact information for ALL employers. If you have more than two, please send a separate email to iss@siue.edu and indicate any additional employers not notated on this form. Type N/A if not available.


Primary Employer Information
Primary Employer / Company Name
Street Address
City
State
Zip Code
Supervisor's Name
Supervisor's Email
Supervisor's Phone#
Job Title

Secondary Employer Information
Secondary Employer / Company Name
Street Address
City
State
Zip Code
Supervisor's Name
Supervisor's Email
Supervisor's Phone#

Self-employed
If you are self-employed please give details of the employment and business address below in the text box.



Have you applied for another Immigration Status? (Example: H-1B, PR etc.)

Yes
No

If yes, what type of immigration status?

H-1B
Permanent Residency
Other
N/A

What is the status of your immigration case?

Pending
Approved
N/A

Enter your case receipt number

Have you permanently departed the U.S.?

Yes
No

If yes, Departure Date:

Are you currently Employed?

Yes
No

Are you currently working as a Volunteer?

Yes
No


** If you are volunteering, please submit a detailed offer letter for your volunteer work to the ISS Office.

** OPT employment cannot be reported until the ISS Office receives the employment Offer Letter for Volunteer work.

** Volunteer work must be 20 hours or more a week.

**If your employment is terminated during your OPT period please send an e-mail to iss@siue.edu.