OPT Student Registration Update Survey

1. Personal Information

Personal Information Family Name:
First Name:
Home Address:
Apt. #
City:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

*

2. Are you currently employed in the United States?

Are you currently employed in the United States? Yes

No

*

3. Employed or Unemployed

	MM		DD		YYYY
as of:	Employed or Unemployed as of: Month	/	Day	/	Year

4. Employer Information:

Employer Information: Company Name:
Company Address:
City:
State:
ZIP Code:

*

5. I have decided to end my OPT early:

I have decided to end my OPT early: Yes (if yes, answer question 6)

No (if no, skip question 6)

6. I will be ending my OPT early

	MM		DD		YYYY
as of:	I will be ending my OPT early as of: Month	/	Day	/	Year

International Students are required to update their personal and employment information with our office while on OPT. If your personal or employment information changes you are required to update your information on our website within 10 days. Please visit us online at www.callutheran.edu/international to update your information in the future.

OPT Student Registration Update
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OPT Student Registration Update
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