Loma Linda University Employer Certification
This is to certify that (Name of F-1 Student)
has been offered on-campus employment at Loma Linda University.
Nature of on-campus employment (e.g., library assistant, research assistant, etc.):
Start Date: ____________ Anticipated end date: _______________ Number of Hours/Week: ___________
Employer information: LLU Employer Identification Number (EIN): 95-1816009
Employer’s Telephone Number:
Immediate Supervisor:
Employer Signature (Original):
Employer’s printed name:
Signatory’s Title:
Loma Linda University Designated School Official (DSO) Certification
I certify that the above named student has been maintaining his/her F-1 Student immigration status and is
eligible, immigration-wise, to accept this on-campus employment offer.
DSO Signature (Original):
DSO’s printed name:
International Student & Scholar Services, 11139 Anderson St., SSC-1201, Loma Linda, CA 92350-1735
Date of DSO’s certification: DSO’s phone number: (909)558-4955
Student’s SEVIS ID#: