Please review this section carefully, sign and date it before you submit it to your DSO. Scanned copies of original signatures or verified electronic signatures could be accepted.

Section 5: Training Plan for STEM OPT Students (completed by student and employer)

In order to better ensure the academic benefit and integrity of the extension, Federal regulations require each STEM OPT student to prepare and execute with his or her prospective employer a formal training plan that identifies learning objectives and a plan for achieving those objectives. The STEM OPT student and his or her employer must work together to finalize the plan.

• Student Name: Enter student's full name (Surname/Primary Name, Given Name) exactly as it appears on the student's SEVIS-issued Form I-20.
• Employer Name: Enter the employer's name, as it appears in "Section 3: Employer Information."
• Site Name: Enter the employer's site name, which may be the same as employer name in Section 3. However, if the student is working for a branch or subsidiary of a large entity, or anywhere other than the headquarters, provide the name of this work site. If working at KSU, Enter Kentucky State University – better with specific department. For example, Kentucky State University – College of Agriculture, Communities, and the Environment.
• Site Address: Enter the exact address of the work site where the STEM OPT will take place.
• Name of Official: Enter the name of the appropriate individual in the employer's organization who is familiar with, and will monitor, the student's goals and performance. This may or may not be the same Employer Official as in Section 4.

If at KSU, you can enter the name of the Dean, or Chair, or Principal Investigator (P.I.) or Faculty Supervisor who signed the Employer Certification.

• Official's Title: Enter the title of the appropriate individual in the employer's organization who is familiar with, and will monitor, the student's goals and performance

If at KSU, Enter Dean or Department Chair, the KSU title of the Principal Investigator (P.I.) or Faculty Supervisor

• Official's Email: Enter the email address of the appropriate individual in the employer's organization who is familiar with, and will monitor, the student's goals and performance.