Get Application For Practical Training

CURRICULAR PRACTICAL TRAINING CPT REQUEST FORM Office of International Student and Scholar Services OISSS All students requesting CPT are required to consult with an OISSS international student advisor. Please call 401 863-2427 to schedule an appointment. Documents which must be submitted to OISSS with this completed request form Signed offer letter from the employer scanned or faxed is acceptable Brown University faculty letter bearing all required signatures see application instructions Copies of current I-20 passport biographical page with expiration page visa and I-94 front and back OR I-94 printout www. cbp.gov/i94 Please submit all documents at least 3 weeks in advance of your intended CPT start date. Last Name First Name Date of Birth U.S. Address Where you live. Street Address Apartment Number City State Zip Code If you live on-campus indicate your box Cell Phone E-mail Anticipated Date of Completion Degree Level e.g. BA PhD List dates of previously approved period s of CPT if applicable CPT Request Begin Date mm/dd/yy End Date mm/dd/yy Part-time/Full-time Employer Name and Address Supervisor Name with Phone Number Declared Concentration s /Field s of study Concentration/Academic Advisor Mandatory Course Enrollment not applicable if internship is degree requirement Instructor Semester Course I have read and understand the Curricular Practical Training CPT instructions. Please call 401 863-2427 to schedule an appointment. Documents which must be submitted to OISSS with this completed request form Signed offer letter from the employer scanned or faxed is acceptable Brown University faculty letter bearing all required signatures see application instructions Copies of current I-20 passport biographical page with expiration page visa and I-94 front and back OR I-94 printout www. cbp*gov/i94 Please submit all documents at least 3 weeks in advance of your intended CPT start date. Last Name First Name Date of Birth U*S* Address Where you live. Street Address Apartment Number City State Zip Code If you live on-campus indicate your box Cell Phone E-mail Anticipated Date of Completion Degree Level e*g* BA PhD List dates of previously approved period s of CPT if applicable CPT Request Begin Date mm/dd/yy End Date mm/dd/yy Part-time/Full-time Employer Name and Address Supervisor Name with Phone Number Declared Concentration s /Field s of study Concentration/Academic Advisor Mandatory Course Enrollment not applicable if internship is degree requirement Instructor Semester Course I have read and understand the Curricular Practical Training CPT instructions. I agree to enroll in the course stated in the CPT request during the term listed above. I will notify OISSS in advance of any changes affecting the terms of the employment and course enrollment listed above e*g* dates employer study abroad/away leave of absence etc*. Please call 401 863-2427 to schedule an appointment. Documents which must be submitted to OISSS with this completed request form Signed offer letter from the employer scanned or faxed is acceptable Brown University faculty letter bearing all required signatures see application instructions Copies of current I-20 passport biographical page with expiration page visa and I-94 front and back OR I-94 printout www. cbp*gov/i94 Please submit all documents at least 3 weeks in advance of your intended CPT start date.