Request for Regular OPT
Personal Information
Name _______________________________________________ UIN ____________________________
Student E-Mail _____________@odu.edu
Phone ______________________
SEVIS ID# N______________________
Current U.S. Address _________________________________________________________________________________
This should be your current address and updated by you via the form on our site. If using another address to get your EAD, put it on the I-765—not on this form.
Please look in LeoOnline and verify that the following addresses are correct:
SEVIS U.S. address:
correct
incorrect but I’ve submitted an
update via the VISA site
SEVIS Home Country address:
correct
incorrect but I’ve submitted an
update via the VISA site
U.S. “Mailing” address:
correct
incorrect but I’ve submitted an
update via LeoOnline
Academic Program Information
Major _________________________
Confirmed Graduation
May
August
December Year __________
Bachelors
Masters
Ph.D.
Expiration Date of Current I-20: ______________________
Level:
Have you submitted an application for graduation?
Yes
No
Is your major on your I-20 correct?
Yes
No
I agree to follow the policies and procedures outlined on the Regular OPT Responsibilities Form.
Signature ____________________________________________________________ Date __________________________
Optional Practical Training
Start Date: ____________________ (within 60 days of program completion) End Date: ____________________
GPD (Graduate
applications)/Chief Departmental Advisor (Undergraduate applications)
Approval
When did or will this student complete his/her coursework?
Month ________________ Year ___________
Student’s confirmed semester of graduation?
May
August
December 20_____
With my signature below, I recommend you authorize this student to participate in Optional Practical Training.
Signature ____________________________________________________________ Date __________________________
Name & Title ________________________________________________________________________________________
Phone ______________________________________ E-Mail ________________________________________________
Holds? Yes No If “yes,” type(s) of hold? ___________________________ GPA ______
Registered? Yes No
# of hours ____
VISA
Semesters under 9/12? ______________________________________________________________________
Place a
over each semester that has an approved RCL.
Only
Graduation Application on SHADEGR? Yes No
Address match: __SEVIS __Banner __ISSM
Workshop?
Yes No
Program shortened?
Yes
No
New OPT Added?
Yes
No
Notes/communication with student:
1
2
3
