J-1 Student On-Campus Employment Authorization Request

Date: 5/30/2015
*Required Filed
* Last Name  
* First Name  
* Email Address  
Employment Information
* Name of Your Employer  
(name of department, office or organization that employs you)
* Nature of Your Work  
(e.g. GA, TA, RA, adjunct instructor, bus driver, server, cashier, student assistant, etc)
* Employment Start Date  
* Employment End Date  
REMEMBER: An authorization letter has a maximum validity of 12 months. If your employment contines beyond the validity date of this letter, you will need to request a new letter by completing another form. If you are working for more than one on-campus employer, please click the 'Additional Employment' button to sumbit the details

If you experience any difficulties with this form, please contact International Student & Scholar Services.
Email: isss@binghamton.edu   Phone: 607-777-2510