J-1 Student On-Campus Employment Authorization Request

Personal Information
Date : 8/30/2008* Required Fields
* 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  (mm/dd/yyyy)
* Employment End Date  (mm/dd/yyyy)

Information
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