17-Month (STEM) Extension Report and Validation Form

17-Month STEM Extension Report (and Validation) Form

While on your STEM-Extension OPT, the Department of Homeland Security requires that you fill out this report every 6 months from the start date on your STEM-Extension EAD card.  After submitting, make sure to print a copy of the Form Handler Confirmation Page as proof of your report.  Due to high demand, IPS is unable to respond to personal requests for confirmation.

* Indicates a required field.

To:   International Programs & Services

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* Employment (Indicate “on-going” if currently employed):  
*Have there been any changes in the above information in the last 6 months?:    
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Be sure to provide IPS with a copy of your current STEM Extension EAD, if you have not done so.