STEM OPT 6 Month Validation Report

Please complete this form every six months if you are an F-1 student currently on a 24-month OPT Extension. This form must be completed within 10 calendar days of 6, 12, 18, and 24 months following the start date of your STEM OPT period. You must submit this report to the International Student Services, even if your employment has not changed.

If you have multiple jobs, you must submit this Validation Report for each job (i.e. if you have two jobs, submit this form twice).

If you have questions about this requirement, please contact the Bellevue University International Student Services at [email protected].

*Please Choose the Month for Reporting:

I am currently employed on STEM OPT.

Employer Information TimeZone

* Employer's E-Verify Number:

* Employer’s Employer Identification Number (EIN):

* Name of Current Employer:

* Employer's Street Address:

* Employer's City:

* Employer's State:

* Employer's Zip Code:

* Employment Start Date (mm/dd/yyyy):

* Full Job Title:

* How many hours per week do you work?

* Employer Official's Full Name:

(Match the official information listed on page 3 your most recent I-983 form.)

* Employer Official's Email:

(Match the official information listed on page 3 your most recent I-983 form.)

* Employer Official's Phone Number:

(Match the official information listed on page 3 your most recent I-983 form.)

* In your words, please explain how your job is related to your major:

I was previously employed on STEM OPT and am now unemployed.

Personal Information:

* First Name:

* Last Name:

* Bellevue University Student ID Number:

* SEVIS ID Number:

Current Mailing Address

* Street Number and Name:

* City:

* State:

* Zip Code:

*Is your mailing address as indicated above the same as your physical address?

Current Physical Address

* Street Number and Name:

* City:

* State:

* Zip Code:

* Current E-mail Address:

* Phone Number:

Documents

At 12-months, you must complete first “Evaluation of Student Progress” portion of the I-983 Form (top box on page 5) , and send it to [email protected], within 10 calendar days of 12 months following the start date of your STEM OPT period.
At 24-months, you must complete and submit a second/final assessment (the bottom box on page 5 of the I-983 Form), and send it to [email protected], within 10 calendar days of 24 months following the start date of your STEM OPT period.
If you change employer while on STEM Extension (if you stop working for an employer, no matter how long the position lasted), you must submit a Final Evaluation (bottom of page 5 of the I-983 Form), and send it to [email protected], within 10 calendar days of the change.

Statement of Understanding (Required)

I understand that I am required to complete this STEM validation report to Bellevue University International Programs every 6 months. I understand I must also report any changes to my contact details or employer information within 10 days of any change. Changes must be reported through the OPT Student Update Form.

I understand that if this is my 12th or 24th month, I must submit the evaluation on page 5 of the I-983 to [email protected] within 10 days of the deadline.

STEM OPT 6 Month Validation Report

Documents

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