Adapted by UW Madisn (and inspired by the University f Michigan) frm the fllwing surce: https://www.ice.gv/sites/default/files/dcuments/dcument/2016/i983instructins.pdf Cmpleting the Frm I 983 TRAINING PLAN FOR STEM OPT STUDENTS Science, Technlgy, Engineering & Mathematics (STEM) Optinal Practical Training (OPT) STEM OPT students and their emplyers are subject t the terms f the Frm I 983, Training Plan fr STEM OPT Students, effective as f the start date requested fr STEM OPT n the Frm I 983. Sectin 1: Student Infrmatin (Cmpleted by Student): Student Name: Enter yur full name (Surname/Primary Name, Given Name) exactly as it appears n yur I 20. Student Email Address: Enter the email address where yu can currently be cntacted. Name f Schl Recmmending STEM OPT: Enter the name f yur schl f mst recent enrllment, frm which the Designated Schl Official (DSO) will be recmmending STEM OPT. If this schl is UW Madisn, please enter University f Wiscnsin Madisn. Name f Schl Where STEM Degree Was Earned: Enter the name f the schl frm which yu earned the degree upn which the STEM OPT is based. This may r may nt be the same schl recmmending the STEM OPT if yu are using a prir STEM degree. SEVIS Schl Cde f Schl Recmmending STEM OPT: Enter the SEVIS Schl cde f the schl recmmending the STEM OPT (including the 3 digit suffix). This wuld be yur current schl r schl f mst recent enrllment. Fr UW Madisn, the schl cde is CHI214F20246000 DSO Name and Cntact Infrmatin: Enter the full name f the advisr wh mst recently signed yur I 20. This can be fund under schl attestatin Fr UW Madisn cntact infrmatin, please use the fllwing: 217 Red Gym, 716 Langdn Street, Madisn, WI 53706 iss@studentlife.wisc.edu 608 262 2044 Student SEVIS ID Number: Enter yur SEVIS identificatin (ID) number. This is n page 1 f yur I 20 and begins with the letter N. STEM OPT Requested Perid: Enter the perid during which yu are requesting t wrk n STEM OPT (regardless f whether the authrized dates match actual training dates). Nte that the STEM OPT extensin may nt end mre than 24 mnths after the scheduled terminatin f the student s Emplyment Authrizatin Dcument fr the current perid f pst cmpletin OPT. Fr a student n 12 mnth OPT requesting a STEM OPT extensin, the start date shuld be the day after yur current 12 mnth OPT ends. Fr a student n 17 mnth STEM OPT requesting cnversin t the terms and cnditins f a 24 mnth STEM OPT extensin, the F 1 student and the student s emplyer will be subject t the terms and cnditins f the Frm I 983, Training Plan fr STEM OPT Students, as f the date f receipt at U.S. Citizenship and Immigratin
Services (USCIS) and thus the requested perid shuld identify a start date n r befre prper filing at USCIS. Qualifying Majr and Classificatin f Instructinal Prgrams (CIP) Cde: Enter yur STEM majr that qualifies yu fr the STEM OPT extensin, as well as the degree s (CIP) cde. Yu can find CIP cdes n the Natinal Center fr Educatin Statistics website at: http://nces.ed.gv/ipeds/cipcde/default.aspx?y=55 r the ICE website at http://www.ice.gv/sevis. Yur CIP cde is listed n page 1 f the new frmat I 20, under Prgram f Study, r n page 3 f the ld frmat I 20. Level/Type f Qualifying Degree: Enter the academic level upn which yu are basing STEM OPT. (Fr example, enter Bachelr s, Master s, r Ph.D.) Date Awarded: Enter the date when the degree, upn which STEM OPT will be based, was awarded r cnferred. Based n Prir Degree? Check Yes if yur STEM OPT participatin is based n a previuslybtained STEM degree, and is nt the same degree upn which yur current pst cmpletin OPT was granted. Check N if yur STEM OPT participatin is based n yur mst recently btained degree, and that is the degree upn which yur current pst cmpletin OPT is based. Emplyment Authrizatin Number: Enter yur USCIS# fund n the Emplyment Authrizatin Dcument (EAD card). Sectin 2: Student Certificatin: Student Certificatin: Review the certificatin and affirm the statement by signature. Sectin 3: Emplyer Infrmatin (Cmpleted by Emplyer): Emplyer Name: Enter yur cmpany, university, etc. name. Street Address, Suite, City, State, Zip Cde: Enter the emplyer r cmpany mailing address. Fr UW Madisn emplyees, the address shuld be: 21 Nrth Park Street, Suite 5101, Madisn, WI 53715 Emplyer Website URL: Enter the emplyer website URL, if available. If n website exists, enter N/A. Emplyer ID Number (EIN): Enter the Emplyer Identificatin Number (EIN). Fr UW Madisn emplyees, the EIN is 39 6006492. Number f Full Time Emplyees in the United States: Prvide the number f full time emplyees in the United States. UW Madisn has 21,000 emplyees. Nrth American Industry Classificatin System (NAICS) Cde: Enter the cmpany s NAICS cde. (Federal statistical agencies use the NAICS cde t classify business establishments fr the purpse f cllecting, analyzing and publishing statistical data related t the U.S. business ecnmy.) NAICS cdes are accessible at http://www.census.gv/cgibin/sssd/naics/naicsrch?chart=2012. UW Madisn s NAICS cde is 611310. OPT Training Hurs per Week: Enter the agreed upn number f average training hurs per week. In rder t qualify fr STEM OPT, the student must wrk a minimum f 20 hurs per week.
Start Date f Emplyment: Enter the date when the student will begin the STEM OPT training with the emplyer. Cmpensatin: Enter the dllar amunt f salary, stipend, and/r ther cmpensatin, and the frequency f pay (per hur, per week, bi weekly, mnthly). Other cmpensatin may include husing, tuitin waivers, transprtatin csts, etc. Nte: The terms and cnditins f a STEM practical training pprtunity (including duties, hurs, and cmpensatin) must be cmmensurate with thse applicable t similarly situated U.S. wrkers, except that a STEM OPT participant must wrk at least 20 hurs per week while emplyed. Sectin 4: Emplyer Certificatin: Emplyer Certificatin: The Emplyer Official with Signatry Authrity, wh is an apprpriate individual in the emplyer s rganizatin, wh is familiar with the student s gals and perfrmance, and wh is an emplyee wh has signatry authrity fr the emplyer shuld review the certificatin and affirm the statement by signature. Fr UW Madisn Emplyees: This shuld be signed by the Department Chair r Center Directr. Nte fr Emplyer Official with Signatry Authrity: The Emplyer Official with Signatry Authrity attestatin includes the certificatin at Sectin 4 (d) which states The student n a STEM OPT extensin will nt replace a full r part time, temprary r permanent U.S. wrker. The terms and cnditins f the STEM practical training pprtunity including duties, hurs, and cmpensatin are cmmensurate with the terms and cnditins applicable t the emplyer s similarly situated U.S. wrkers r, if the emplyer des nt emply and has nt recently emplyed mre than tw similarly situated U.S. wrkers in the area f emplyment, the terms and cnditins f ther similarly situated U.S. wrkers in the area f emplyment. Sectin 5: Training Plan fr STEM OPT Students (Cmpleted by Emplyer): In rder t better ensure the academic benefit and integrity f the extensin, Federal regulatins require each STEM OPT student t prepare and execute with his r her prspective emplyer a frmal training plan that identifies learning bjectives and a plan fr achieving thse bjectives. The STEM OPT student and his r her emplyer must wrk tgether t finalize the plan. Student Name: Enter the student s name (Surname/Primary Name, Given Name) exactly as it appears n the student s SEVIS issued Frm I 20, Certificate f Eligibility fr Nnimmigrant (F 1) Student Status Fr Academic and Language Students. This shuld als match the student s name as it appears in Sectin 1: Student Infrmatin. Emplyer Name: Enter the emplyer s name, as it appears in Sectin 3: Emplyer Infrmatin. Site Name: Enter the emplyer s site name, which may be the same as emplyer name in Sectin 3. Hwever, if the student is wrking fr a branch r subsidiary f a large entity, r anywhere ther than the headquarters, prvide the name f this wrk site. Site Address: Enter the exact address f the wrk site where the STEM practical training will take place. Fr UW Madisn emplyees, this sectin shuld be cmpleted with department specific infrmatin.
Name f Official: Enter the name f the apprpriate individual in the emplyer s rganizatin wh is familiar with, and will mnitr, the student s gals and perfrmance. This may r may nt be the same Emplyer Official as in Sectin 4. Official s Title: Enter the title f the apprpriate individual in the emplyer s rganizatin wh is familiar with, and will mnitr, the student s gals and perfrmance. Official s Email: Enter the email address f the apprpriate individual in the emplyer s rganizatin wh is familiar with, and will mnitr, the student s gals and perfrmance. Official s Phne Number: Enter the phne number f the apprpriate individual in the emplyer s rganizatin wh is familiar with, and will mnitr, the student s gals and perfrmance. Student Rle and the Training Prgram s Direct Relatinship t the Student s Qualifying STEM Degree: Describe what tasks and assignments the student will carry ut during the training and hw these relate t the student s STEM degree. The plan must cver a specific span f time, and detail specific gals and bjectives. Gals and Objectives: Describe the specific skills, knwledge, and techniques the student will learn r apply; hw the student will achieve the gals set ut fr his r her training; and the training curriculum including the timeline. Emplyer Oversight: Explain hw the emplyer prvides versight and supervisin f individuals filling psitins such as that being filled by the named F 1 student. If the emplyer has a training prgram r related plicy in place that cntrls such versight and supervisin, a descriptin f this prgram r plicy may suffice t answer the questin. Measures and Assessments: Explain hw the emplyer measures and cnfirms whether individuals filling psitins such as that being filled by the named F 1 student are acquiring new knwledge and skills. If the emplyer has a training prgram r related plicy in place that cntrls such measures and assessments, a descriptin f this prgram r plicy may suffice t answer the questin. Additinal Remarks. Prvide any additinal pertinent infrmatin. Sectin 6: Emplyer Official Certificatin: Certificatin f Official with Signatry Authrity: Nte: The individual wh signs this Certificatin need nt be, but can be, the same individual wh signed the Emplyer Certificatin in Sectin 4. An emplyee with signatry authrity fr the emplyer shuld review the certificatin and affirm the statement by signature. On the material change certificatin (#4), please nte that material changes in the plan can include (but are nt limited t) the fllwing: any change f Emplyer Identificatin Number resulting frm a crprate restructuring, any reductin in cmpensatin frm the amunt previusly submitted n the Frm I 983, Training Plan fr STEM OPT Students, that is nt tied t a reductin in hurs wrked, any significant decrease in hurs per week that a student engages in a STEM training pprtunity, and any decrease in hurs belw the 20 hurs per week minimum required under this rule. Fr UW Madisn emplyees, this sectin shuld be signed by the PI r supervisr. Evaluatin n Student Prgress: If yu are submitting the I 983 fr the first time yu shuld nt cmplete pages 6 and 7
Student evaluatins are a shared respnsibility f bth the student and the emplyer t ensure that the student s practical training gals are being satisfactrily met. The student is respnsible fr cnducting a self evaluatin based n his r her wn training prgress. The emplyer must review and sign the self evaluatin t attest t its accuracy. The student submits the first assessment within twelve mnths and a final evaluatin that recaps all the training and knwledge acquired during the cmplete training perid. Enter the range f the student evaluatin dates (the timeline fr which this evaluatin is relevant). The student must sign, print name, and enter date f signature. The Emplyer Official with Signatry Authrity must sign, print name, and enter the date f signature t shw cncurrence with the assessment infrmatin that the student has entered.