Optional Practical Training Reporting

This form is to be used by F-1 students/past students who are currently participating in OPT and still on an I-20 issued by the University of Iowa.  All information is required unless otherwise specified.

Contact Information

First/Given Name:

Last/Family Name:

Email:

HawkID:

Current Residential Address

Street Address:

Street Address:

City:

State:

Zip Code:

Current Mailing Address
(If Different From Residential Address)

Street Address:

Street Address:

City:

State:

Zip Code:

Reporting Information

Have You Changed to Another Immigration Status?
(Example: H-1B, green card, etc.)

Yes No

What is your new status?

Have you permanently departed the U.S.?

Yes No

Departure Date:

Are You Currently Employed?

Yes No

If yes, the following information is required:

Primary Employer / Company Information

Primary Employer / Company Name:

Supervisor's Name:

Supervisor's Email:

Street Address:

Street Address:

City:

State:

Zip Code:

Secondary Employer / Company Information

Secondary Employer / Company Name:

Supervisor's Name:

Supervisor's Email:

Street Address:

Street Address:

City:

State:

Zip Code:

Multiple Employers

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 ip-sevis@uiowa.edu to indicate additional employer information.

Self-Employed

If you are self-employed, please write “self-employed” in the Employer Name field and give the business address you use.

Performing Arts People with Multiple Gigs

If you are self-employed, write “self-employed” in the Employer Name field.  You also need to send OISS a list of gigs on a regular basis by emailing ip-sevis@uiowa.edu .  If you are employed by an agency, provide the agency’s name/address information.