International Students and Scholars Office

Part 1: Reason for Applying

F-1 Students: 

• Check “Initial permission to accept employment” for an OPT application and a STEM OPT Extension application. 
• If you lost your EAD and are applying for a new EAD, select "Replacement of Lost, Stolen, or Damaged Employment Authorization Document NOT DUE to US Citizenship and Immigration Services (USCIS) Error."

J-2 Visa Holders:

• If you do not have an EAD based on your current J-2 status, check the box “Initial Permission to Accept Employment.” 
• If you were already issued an EAD under J-2 status and are renewing your EAD, check “Renewal of My Permission to Accept Employment." 

Part 2: Information About You

• Enter your name exactly as stated on your passport.
• If you have another name that you use, such as an alias, nickname, and/or your maiden name (name used prior to marriage - typically applies to women who are married and have changed their last name) - please list them in the “Other Names Used” section.

• The address you are listing here should be valid for a least the next 3-5 months - USCIS will mail all correspondences to this address. 
• If you are using a friend's address (where you do not reside) be sure to list your friend's name in the “In Care of Name (if any)” line.
• If the address you provide is not the same as your physical address, make sure you select the “No” choice and then proceed to provide your current physical U.S. Address.

We request that you not use the Brandeis University ISSO mailing address unless you have first spoken with your ISSO advisor.

Answer these questions pertaining to you.

• If the Social Security Administration has not issued you a social security card, please answer the questions and follow the instructions.
• You only need to provide your parent’s names if you want to request a Social Security card.
• You will need to list all countries of which you have citizenship.
• If you need to input additional information, you may utilize Part 6.

Answer All Questions Up to Question 27

Question 27, Answer if you are applying for:

• Pre-Completion OPT (work authorization before you graduate):  Answer (c) (3) (A)

• Post-Completion OPT (work authorization after graduation): Answer (c) (3) (B)

• STEM OPT Extension: Answer (c) (3) (C)

• J-2 Work Authorization: Answer (c) (5)

Question 28, Answer ONLY if you are applying for the OPT STEM Extension

Answer Question 28 (28.a, 28.b and 28.c)

Questions 29-31, Do not apply, so you may leave them blank. 

Check the appropriate box in the Application Statement.

• Provide your contact information. 

Please Note: Page 4, part 3 of the Form I-765 states "You must file Form I-765 while in the United States." 

Reminder: The instructions for the Form I-765 state, "If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-765, we will deny your Form I-765 and may deny any other immigration benefit."  

Sign and date the application by hand. Electronic signatures will not be accepted by USCIS.

Complete the interpreter's contact information only if you had an interpreter or agent complete this form on your behalf.

Complete this page if you have additional information to provide, such as additional countries of citizenship, employment authorization you received in the form of Curricular Practical Training (CPT) or Optional Practical Training, and/or previous SEVIS ID numbers.

• Question 1: Based on your name
• Question 2: Answer only if you have an A-number, if you do not have an A-Number, leave this blank
• Question 3: Answer only if  you had a previous SEVIS ID number as noted on 

• Include:
  • Current SEVIS ID
  • Degree Level
  • Previous Employment Authorization (CPT or OPT) Start and End Dates
  • Part-time or Full-Time