OPT/OPT STEM Reporting

Name*
First Last
Student Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Personal Phone Number*
Personal Email*
Report Type*
Employment Information
Company Name*
Company Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company EIN Number
E-Verify Number
Job Title*
Employment Start Date*
MM slash DD slash YYYY
Employment End Date
MM slash DD slash YYYY
Hours of employment per week*
Brief Statement*
Please provide a brief (2-3 sentence) statement describing how your employment relates to your coursework while attending Rivier University
Important reminder for OPT STEM applicant: Submit a new and completed Form I983 (pdf) whenever you report a change of employer to globalengagement@rivier.edu Your OPT STEM update is not complete without submitting that required form.

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