Fillable Curricular Practical Training Application (Lesley University)

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Curricular Practical Training Application (Lesley University)

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Curricular Practical Training Application
International Student Services ♦ 7 Mellen Street ♦ iss@lesley.edu ♦ 617-349-8426
Page 1 of 3
Ver. 4/16
Curricular Practical Training (CPT) is a type of work authorization F-1 students can use to do a job,
internship, practicum, fieldwork, co-op, etc. that is directly related to their field of study.
In order to be eligible for CPT, you must:
Have completed at least two semesters in F-1 Status
Be doing your internship for academic credit or as part of a degree requirement
Be a current Lesley student
Have an offer for a position which is directly related to your field of study
If you aren’t sure if you meet the eligibility requirements, contact ISS before you complete this form
ISS authorizes you to work on CPT by creating a new I-20 for you. Your CPT I-20 will authorize you to work
either part-time (20 hours per week or less) or full-time (over 20 hours a week). During the Fall and Spring
semesters, you may work part-time only, unless your program requires that you work full-time.
You may not start working until your receive your CPT I-20, and you may work only for the dates indicated
on your I-20. You may only work for the one company or organization you apply with; if you need to
changes jobs while on CPT, you must contact ISS first.
Instructions:
Step 1:
Attend an employment workshop or
Review the CPT guide (http://www.lesley.edu/international-students/immigration-forms/) and
Contact ISS with any questions about applying for CPT
Step 2:
Complete page 1 of your CPT form, and give page 2 to your academic advisor to complete
Enroll for your internship course (if applicable)
Step 3:
Submit the following to ISS at 7 Mellen Street or via email at iss@lesley.edu:
o Both pages of the completed CPT application
o A copy of your internship offer letter
Step 4:
Once ISS has reviewed your application we will contact you to make an appointment within 1 week
During that appointment, we will create your CPT I-20 and give it to you
Curricular Practical Training Application
International Student Services ♦ 7 Mellen Street ♦ iss@lesley.edu ♦ 617-349-8426
Page 2 of 3
Ver. 4/16
For Student To Complete and Sign:
Name __________________________________________________________________________________
Family/Last Given/First Middle
Local Address ___________________________________________ Phone ______________________
Street Apt
___________________________________________ Student ID# __________________
City State Zip Code
Lesley E-mail ________________________________ SEVIS ID#___________________________
Major ______________________________________ I-20 Expiration Date __________________
How many hours per week do you plan to work? Part Time (20 hours per week or less)
Full Time (Over 20 hours per week- summers only)
When do you plan to graduate? __________________________
Is the internship/practicum required by your degree program? Yes No
Will you receive course credit for the internship? Yes No
If yes, please give the course title and number: ________________________________
If your answer to both the above questions is no, please contact ISS before you complete this form
Describe how your internship will be directly related to your field of study:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Employer Name __________________________________________________________________________
Employer Address ________________________________________________________________________
Street City State Zip Code
Employer Phone ___________________ Supervisor’s Name ________________________________
I certify that the above information is correct
I will only work for the employer listed above, and I will let ISS know before I change jobs
I will only work during the CPT dates indicated on my I-20
I understand that if I am authorized for part-time CPT, I cannot work more than 20 hours/week
I understand that if I drop my internship course, I must stop working and let ISS know
I will let ISS know if my internship ends earlier than expected
Student Signature _____________________________________ Date____________________
Curricular Practical Training Application
International Student Services ♦ 7 Mellen Street ♦ iss@lesley.edu ♦ 617-349-8426
Page 3 of 3
Ver. 4/16
For Academic Advisor to Complete and Sign:
Name of Student: ___________________________________________ID#: ______________________
First name Last name
Major: __________________________________ First Semester of Enrollment: _____________
Dear Academic Advisor:
CPT is a type of work authorization current students can use to do a job that is related to their field of
study. CPT can be authorized for either required internships, or elective internships for which the student
is earning academic credit.
Your verification of the student’s information is needed to insure that Lesley University is in compliance
with immigration regulations.
I verify that, to the best of my knowledge, the information the student has provided is correct.
I verify that this student’s proposed internship is directly related to his or her field of study.
I verify that this internship is either a degree requirement, or that this student will receive
academic credit for this internship.
Name of Academic Advisor: ____________________________________________________________
Department/Program: _________________________________________________________________
Signature: ________________________________________ Date: ___________________________
Email: ____________________________________________ Phone: __________________________
If you have questions, please contact Laura Kanner at lkanner@lesley.edu or 617-249-8415
FOR ISS USE ONLY
Completed Form Offer Letter
Internship Course Enrollment Anticipated Graduation Date ______________
Academic Standing __________ Needs SSN? If so, SSA Letter
CPT Approved: Sign and Date _________________________________________________________
CPT Denied: Reason, Sign and Date:
_________________________________________________________________________________
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Completed 22 July 2020

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