Eastern Kentucky University

Office of International Student and Scholar Services

Home 9 Forms 9 12-Month Post-completion OPT Change of Employer

12-Month Post-completion OPT Change of Employer

PERSONAL INFORMATION

First Name *

Last Name *

SEVIS ID# *The SEVIS ID# is found on your I-20 and it begins with the letter “N” followed by 10 numbers.

EKU ID# *

Your Residential Street Address *

Apartment, suite, etc.

City *

State *

ZIP / Postal Code *

Email Address *

Phone Number *

OLD EMPLOYER INFORMATION

Please submit details of your old employer below.

Name of old employer *

Start date of old employment *

Year

Month

Day

End date of old employment *

Year

Month

Day

NEW EMPLOYER INFORMATION

Your Job Title *

Explain how this employment is related to your major field of study *Your written explanation, should include your job title, employer name, major area of study, whether full time or the average hours worked per week, and a brief explanation of how the job is directly related to your studies. The regular duties should be explained and the connection between those duties and the degree described.

Start date of employment *

Year

Month

Day

Name of Employer *

Address of Employer *

Apartment, suite, etc.

City *

State *

ZIP / Postal Code *

Employer Identification Number (EIN)(Format 00-0000000) *Please ask your supervisor or Human Resources Department to obtain the Employer Identification Number. EIN is a nine-digit number assigned by the U.S. Internal Revenue Service (IRS).

Please upload your job offer letter here *

No file chosen

You can only upload files 8MB or smaller.

SUPERVISOR INFORMATION

First Name of Supervisor *

Last Name of Supervisor *

Title of Supervisor *

Email Address *

Phone Number *

SITE OF EMPLOYMENT

Please enter the address of the location you are working at below.

Street Address *

Apartment, suite, etc.

City *

State *

ZIP / Postal Code *

RECEIVING YOUR I-20

Once your SEVIS record has been updated, OISSS will mail your I-20 by regular US Postal Service to your address within 5 business days. You may choose other options below to receive your I-20.

How do you want to receive the new I-20? *Pick up in person from Whitlock Building, Room 455.Express Mail Service via eShipGlobal.Pick up by friend or relative, whose contact information is below.

Friend's or relative's namePicture ID will be required to pick up the I-20.

Friend's or relative's phone number

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