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Cpt-evr-formweb - CPT EVR Form

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U.S.A. forms for NorthWest Arkansas Community College

BROWSE NORTHWEST ARKANSAS COMMUNITY COLLEGE FORMS

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
Pleaseprovidethepositiontitleandbasicdescriptionofresponsibilities forthe
positionyouhaveofferedforthestudent(useadditionalpagesifneededor
attachjobdescription).
Pleasecompletethefollowingformtoenablethisstudenttoobtainemployment
authorizationunderCPT.Onceyouhavecompletedthisform,
pleasereturnit
tothestud
entsothattheymaysubmitittoourofficeforreview.
Ifyouhavequestionsorconcerns,pleasecontactusattheInternationalPrograms
Office:479‐619‐2224orjyoumans@nwacc.edu
CompanyName:______________________________________________
WorksiteAddress:______________________________________________
City: ______________________________________________
State,Zip: ______________________________________________
ThisstudentmaynotworkbeforethestartdateorpasttheenddateoftheCPT
Authorization.
DateScheduledtoBegin:_________________________________________
DateScheduledtoEnd:_________________________________________
CurricularPracticalTrainingmaybegrantedoneitheraPartTimeor
FullTimebasis.Forimmigrationpurposes,PartTimeisdefinedas20hoursorless
perweek,NOTTOEXCEED20hoursinanyweekduringtheperiodofauthorization.
FullTimeisdefinedbyanyamountoftimegreaterthan20hoursperweek.
HoursPerWeekStudentisExpectedtoWork:______________________________
CouldHoursincreasetoFullTimeinanygivenweek: Yes No
IfhoursdogoabovePareTime,willyounotifyus: Yes No
Pleasenotethefollowing:
*ThestudentmayNOTbeginemployment(includinganytypeofcompensated
trainingororientationprograms)untilreceivingwrittenauthorizationfromour
office.
*Whenproperlyauthorized,thestudentwillbeabletoprovideyouwithacopy
oftheimmigrationFormI‐20
,showingthedatesforwhichtheyhave
beengrantedauthorizationforemploymentwithyourCompany.
*Thestudentmaynotbeginemploymentpriorto,orcontinueemployment
beyond,thedateslistedontheFormI‐20
.Ifyouwishtoextendthe
student’sofferofemploymentbeyondtheenddatelistedontheI‐20/DS‐2019,
thestudentwillneedtoobtainanewperiodofCPTemployment
authorization.Thismustbedoneonasemesterbysemesterbasi
s.
Employer’s
Representative:__________________________________________
Representative’sSignature:__________________________________________
Representative’sTitle:______________________________________________
EmailAddress:_____________________________________________________
PhoneNumber:__________________ Date:_________________________
Student’sName:________________________________________________
StudentNWACCID:
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Completed 12 February 2020

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