Fillable Certification by Designated School Official (Loma Linda University)

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Certification by Designated School Official (Loma Linda University)

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SECTION A. This section must be completed by student as appropriate ( Please print or type) :
1. Name: 2. Date of birth:(First) (Middle)(Family in CAPS)
3. Student admission number: 4. Date first granted F-1 or M-1 status:
5. Level of education being sought: 6. Student's major field of study:
7. Describe the proposed employment for practical training:
Number of hours per week:Beginning date :
Ending date:
8. List all periods of previously authorized employment for practical training:
A. Curricular or work/study: B. Post completion of studies
Signature of student: Date:
SECTION B.
9. I hereby certify that:
The student named above:
Is taking a full course of study at this school, and the expected date of completion is:
Is taking less than a full course of study at this school because:
Completed the course of study at this school on (date):
Did not complete the course of study. Terminated attendance on (date):
Check one:
A. The employment is for practical training in the student's field of study. The student has been in the
educational program for at least 9 months and is eligible for the requested practical training in accordance
with INS regulations at 8CFR 214.2(f) (10).
B. The endorsement for off-campus employment is based on the wage-and-labor attestation filed by the
employer in accordance with the requirements set forth by the Secretary of Labor. The student has been
in F-1 status for at least one year and is in good academic standing. Copy of the employer's attestation is
attached.
C. The employment is for an internship with a recognized international organization and is within the scope of
the organization's sponsorship. The student has been in F-1 status for at least 9 months and is in good
academic standing.
10. Name and title of DSO.
Signature:
Date:
11. Name of school: School file number: Telephone no.:
For Official Use only
(See instructions on reverse)
U.S. Department of Justice
Immigration and Naturalization Service
OMB Approval No. 1115-0060
Certification by Designated School Official
This Section must be completed by the designated school official of the school the student
is attending or was last authorized to attend:
Microfilm Index Number:
Form I-538 (Rev. 09/18/00)Y
Loma Linda University
LOS 214F 00109000
909-558-4955
Instructions
Comments:
A student seeking authorization for off-campus employment (F-1 only) or practical training (F-1 and M-1)
must submit as supporting documentation to Form I-765, Application for Employment Authorization, a
certification by the designated school official (DSO) of the school the student was last authorized to
attend. Certification by the DSO is required of all students (F-1 and M-1) seeking authorization for
employment of campus or practical training, including required or optional curricular practical training.
The DSO must certify on Form I-538 that the proposed employment is directly related to the student's
field of study. A copy of the DSO's certification must be mailed to the STSC date processing center, P.O.
Box 140, Highway 25 South, London, KY. 40741.
All students requesting school certification must complete questions 1 through 6. Students requesting
recommendation for practical training must complete questions 7 and 8. Answers to questions 7 through
9 may be continued on this page if needed.
M-1 students seeking extensions of stay must submit a completed Form I-539, Application to Extend
time of Temporary Stay, supported by a current Form I-20M-N as appropriate.
Reporting Burden
Public reporting burden for this collection of information is estimated to average 4 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: U.S. Department of Justice, Immigration and Naturalization
Service, HQPDI, 425 I Street N.W., Room 4034, Washington, DC 20536; OMB No. 1115-0060.
DO
NOT MAIL YOUR COMPLETED APPLICATION TO THIS ADDRESS.
Form I-538 (09/18/00)Y Page 2
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Certification by Designated School Official (Loma Linda University)

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Completed 22 August 2020

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