Clear Form
International Programs and Services 200 Administration Building 1400 Townsend Drive Houghton, Michigan 49931‐1295 Tel: (906) 487‐2160 Email: ips@mtu.edu
Recommendation Form for
Optional Practical Training (OPT) This information is required by the IPS Office for students in F‐1 visa status requesting 12‐month Post‐Completion OPT (off‐campus) employment signed by the student’s academic advisor, department chair or graduate program director. Note: students CANNOT work on or off‐campus after the program end date on the I‐20 & until they receive the EAD Card To Be Completed By Student First and Last Name Undergraduate Student Michigan Tech ID M Graduate Student
Proposed OPT Start Date* *You may request a start date up to 60 days after program end date. The effective date of the Employment Authorization
Document (EAD) issued by USCIS will be either the requested start date, or the date USCIS approves the application for work authorization, whichever occurs later. Skip the employer and job questions if you do not have a job offer and check box "I have not yet secured employment"
Proposed Employer Name (company, Business, employment agency or University) and address Proposed work address and/or company name, if different I have not yet secured employment nor do I have an official employment offer. I intend to stay in the U.S. as long as I am legally permitted for the purpose of seeking employment that is related to my field of study. If you have a job offer, you must complete and submit the Employer Informaiton Form before your OPT review
appontment: http://www.mtu.edu/international/forms-info/status/change-opt/
Michigan Tech is required by federal regulation to continue to maintain your SEVIS record for the full period of Optional Practical Training, including any extension. By signing this form below, I certify that the above information is true and correct, and that I understand and will comply with the following SEVIS requirements: 


I will report any changes to my U.S. address within 10 days in Banweb
I will report any changes in employment information (including periods of unemployment) to International
Programs and Services within ten days of the change
I understand that while authorized for Post‐Completion OPT, I cannot be unemployed for more than an aggregate
of 90 days
_/_ Student Signature _/_ Date To Be Completed By Academic Advisor, Department Chair or Graduate Program Director The student listed below is requesting a recommendation for employment authorization in his/her field of study. In order to issue a recommendation, IPS is required to obtain the following information. Please complete and sign below. If further information is advisable or necessary, describe in an accompanying letter. Master’s and Ph.D. students may define program completion as the day when all coursework is completed. Students may apply for post‐completion OPT if all they have is thesis remaining. However, students must complete their degree requirements within the 12 month OPT period. This is to confirm that: Student Name:________________________________________________________________________________ 1. Is expected to complete or has completed required coursework for the degree (not including
report/thesis/dissertation) Date: Month/Day/Year 2. Is expected to complete all degree requirements (including report/thesis/dissertation)
Date: Month/Day/Year By signing, I agree that I have met with the student, have reviewed the proposed employment or have discussed how this employment applies to the student’s academic plan. Academic Advisor Printed Name
Academic Advisor Signature
Date Month/Day/Year NOTE: If the student does not graduate by the above date and has applied for Post-Completion OPT,
they must contact IPS immediately to apply for a Program Extension and discuss the loss of full-time OPT.
revised 12/09/2015 Michigan Technological University is an Equal Opportunity Educational Institution/Equal Opportunity Employer, which includes providing equal opportunity for protected veterans and individuals with disability