International Student Services
Curricular Practical Training (CPT) Faculty & Advisor Verification Form
century.edu | 651.779.3300
3300 Century Avenue North, White Bear Lake, MN
55110
1
Curricular Practical Training (CPT): must be an integral part of an established curriculum. Federal regulations
define it as a type of alternate work/study, internship, co-operative education, or any other type of required
internship or practicum which is offered by sponsoring employers through cooperative agreements with the school.
CPT Eligibility:
The student must be in valid F-1 student status at the time of application and have been in full-time status at a
DHS-approved school for one academic year preceding the CPT application.
The student must enroll in at least one credit related to CPT for each semester (including summer) which CPT is
authorized.
The student requesting part-time CPT authorization is required to maintain a full-course of study (12 credits).
Full-time CPT is only an option for students approved for Reduced Course Load in their final term.
Authorization MUST be granted by International Student Services before employment may begin (annotated on
I-20).
Part 1. To Be Completed by the Student: Please Type or Print Clearly
Student Name: ________________________________________________________________________________
Student ID: ______________________ Phone:__________________ Email_______________________________
Degree Program: _____________________________ Anticipated Graduation Date: ___________________
I-20 Expiration date: ______________________ Passport Expiration date: ______________________
Visa Expiration date: ______________________
CPT Site/Employer: ____________________________________________________________________________
CPT Site/Employer Address: _____________________________________________________________________
Position Title: _________________________________________________________________________________
Requested Dates of Practical Training/Internship: ____/____/_____ to ____/____/_____
Hours per week: ____ 1-20 (part-time) ____ 21-40
I certify that the above information is correct. I understand that it is my responsibility to register and stay registered
for the required internship or elective course to satisfy the USCIS curricular practical training regulation. I
understand that if I am requesting part-time curricular practical training authorization, my total work hours cannot
exceed 20 hours/week. I also understand that if granted part-time practical training authorization, I am required to
maintain a full-course of study.
__________________________________________________________ __________________________
Student Signature Date
Century College is a member of Minnesota State. We are an affirmative action, equal opportunity employer and educator. This document
can be available in alternative formats to individuals with disabilities by calling 651.773.1745 or emailing access.center@century.edu.
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Updated 02/05/2020
century.edu | 651.779.3300
3300 Century Avenue North, White Bear Lake, MN
55110
2
Part 2. To Be Completed by the Faculty:
According to the U.S. Citizenship and Immigration Services, the proposed practical training must be an integral part
of the established curriculum in order to be authorized Curricular Practical Training (CPT). Please contact
International Student Services if you have questions about CPT. At least one of the following criteria must be met.
Please check the appropriate item for the student’s proposal:
Program Requirement, Required Course: The student is required to be engaged in the proposed practical
training by their declared program.* This requirement is published in the Century College catalog. This
internship cannot be used to fulfill open elective requirements.
Course Title & Number: _________________________________________ Number of Credits: _____
Program Requirement, Optional Course: The proposed practical training is required by a specific course as
an option of the student’s declared program* requirements. The course must be listed in the Century College
Catalog and the faculty’s signature confirms that the course is considered an integral part of the student’s
program.
Course Title & Number: _________________________________________ Number of Credits: _____
*Declared program may be degree, diploma, or certificate.
By signing below, I indicate that the above information is true based on my best knowledge and information.
________________________________________________________________________________________
Faculty Signature Date
________________________________________________________________________________________
Faculty Name (please print) Phone
________________________________________
Academic Department
Part 3. To Be Completed by the DSO Academic Advisor:
Please verify and check each box below.
This curricular practical training meets a requirement in the student’s declared program at Century College.
This curricular practical training is directly related to the student’s primary major in SEVIS (Major 1).
By signing below, I indicate that the above information is true based on my best knowledge and information.
________________________________________________________________________________________
DSO Academic Advisor Signature Date
________________________________________________________________________________________
DSO Academic Advisor Name (please print)
Students must make an appointment to meet with an International Student Advisor to review completed CPT forms
and request CPT in SEVIS at least 10 business days prior to starting practical training. Contact International
Student Services with any questions.
International Student Services international@century.edu 651-779-3344 Room W1221
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