Academic and Payment Verification Form for OPT Application
Student Section (please print):
Student Name_______________________________________________________________
Student ID Number__________________
Academic Advisor’s Name_____________________________________________________
** Ask your Academic Advisor to complete the next section. **
Advisor Section (please check the appropriate boxes):
□ Student’s cumulative GPA is 2.0 or greater (UG) or 3.0 or greater (GR)
□ Student’s GPA in major is 2.5 or greater (UG)
□ Student is currently enrolled
□ Student has been enrolled full-time for the past academic year
□ Student is in his/her last term, and is attending classes and making progress
□ Student is eligible for conferral upon completion of the current session
Comments:
_______________________________________ __________________
Advisor’s Signature Date
** Ask Student Account to complete the next section. **
Student Account Section (please check the appropriate boxes):
This student account balance is $0 □ Yes □ No
Comments:
_______________________________________ __________________
Student Account Signature Date