All Harvard F-1 students on OPT are required to report to the HIO any of the following changes within 10 business days: Name and address of employer Any change of name of student or residential address Any interruption of employment Given Name * Last Name * SEVIS ID * (The SEVIS ID is found on your SEVIS Form I-20 in the top left hand corner, beginning with the letter "N". Format your entry like this: "N1234567890") Are you employed? * Yes No Employment Are you self-employed? * Yes No If yes, please indicate your primary work location in the employer address field Is this new employment? * Yes No Is this concurrent employment? * Yes No Is this employment replacing a previous employment? * Yes No If yes, what is the end date of that employment? Job Title * Start Date * Year Year20152016201720182019 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Relationship to Degree * Describe how the position draws on knowledge gained and developed during your program in 2-3 sentences. For example, you may cite specific coursework; dissertation or thesis research; or lab work that has provided you with fundamental knowledge you use in your job duties. Is this full-time employment (20 hrs per week or more)? * Yes No Employer Name * Address 1 * Address 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Where do you currently reside? * In the U.S. Outside of the U.S. Current Residential Address Address 1 * Address 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Telephone Number * Foreign Address * Please list your foreign address Email address * This employer update will not generate a new I-20. If you need an updated travel signature, please contact your HIO Advisor. The HIO must be able to communicate with you. Therefore please provide a primary e-mail address which you will use during your F-1 visa status.
