STEM OPT 6-Month Validation Report

Use this form to verify STEM OPT employment information. This validation report is required 6 and 18 months following the start of your STEM OPT period.

Name*

First Name

Last Name

Student ID*

Recommended. You may enter zeros if you don't remember it.

Email*

Have you changed your place of residence and need to report a new address?*

Yes No

What is your new address?

Address Line 1

Address Line 2

City

State

ZIP Code

Current Employment Information

Employer/Company Name*

Employment Start Date (if earlier than the date of STEM OPT Extension start date)*

Employment Address*

Address Line 1

Address Line 2

City

State

ZIP Code

STEM OPT Extension Start Date:*

Have you had a change in supervisor in the past 6 months?*

Yes No

Please note any significant STEM OPT employment changes that have occurred within the past 6 months here.

Name of Supervisor*

First Name

Last Name

Supervisor's Phone*

Supervisor's Email*

I certify I have read DHS's STEM OPT HUB and the information I have provided, is to the best of my knowledge, accurate. I understand I am required to complete STEM OPT employment validation at 6, 12 and 18 months. Additionally, I understand I should report address changes within 10 days of any change, either by creating my own SEVP Portal account, or by emailing international_students@rush.edu .

Click here to certify.

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