19a.-19.c. Enter the name of city, town, or village; state or province; and country where you
were born. Enter the name of the country as it was named when you were born, even if the
country no longer exists.
20. Enter you date of birth in mm/dd/yyyy format in the space provided. For example, enter
October 5, 1994 as 10/05/1994.
Information About Your Last Arrival in the United States
21.a. Enter your Form I-94 Number. Most students can find their I-94 Number by visiting the
CBP website at https://i94.cbp.dhs.gov. If you last entered the U.S. before April 30,
2013, you might have a paper version of the I-94. The Form I-94 Number is also known
as the Departure Number on some versions of the form.
21.b.-21.e Enter your passport or travel document number if you used one to travel to the
U.S., even if it is currently expired
21.b. Enter passport number
21.c. Enter travel document number if any
21.d. Enter Country that issued passport or travel document
21.e. Enter expiration date of passport or travel document
22. Enter the date that you last entered the U.S., using the mm/dd/yyyy format. See your I-94.
23. Enter the Place of your last arrival into the U.S. You can enter an airport code or airport
name. See your I-94.
24. Enter the letter and number that matches your current immigration status when you last
entered the U.S.. For example, if you were an F-1 student when you last entered the U.S.,
enter “F-1.”
25. Enter the letter and number that matches your current immigration status. For example, if
your current immigration status is F-1 student, enter “F-1.” If you have not changed your
status since you last entered the U.S., your entry for 25 and 26 should match.
26. Enter your SEVIS number from your OPT I-20.
Information About Your Eligibility Category
27. In the three boxes, enter the eligibility category based on your situation:
Pre-Completion OPT: (c) (3) (A)
Post-Completion OPT: (c) (3) (B)
STEM extension OPT: (c) (3) (C)
28.-28.c. If you entered eligibility category (c) (3) (C) in 27., enter your degree level, major
and CIP code (for example, Bachelor’s degree in Mathematics, 27.0101), your employer’s
name as listed in E-Verify, your employer’s E-Verify Company Identification Number, or a
valid E-Verify Client Company Identification Number.
29.-31.b. Skip these questions. They do not apply to F-1 students applying for OPT.