ࡱ> QSPa ~*bjbj ..xEbxEb4  $$,&t& & & & & & &$P(+X-&i@-&$$& $R& & :+%,v"%PbXW% %&0&a%R^+^+%^+%@ -&-& &^+ B :  Office of International Student and Scholar Services REQUEST FOR PRACTICAL TRAINING (OPT or CPT) Rev. 05/19 STUDENT SECTION Name________________________________________ NSU ID# __________________________ Address______________________________________ E-mail_____________________________ ______________________________________ Major______________________________ Home Phone_________________________________ Work Phone_________________________ Level of Study qUndergraduate qGraduate Have you held a Graduate Assistantship? qYes qNo If  yes , please list the semesters: If you are a graduate student who is NOT graduating, have you completed all coursework? qYes qNo Employment is defined as the part-time or full-time rendering of services for compensation, financial or otherwise. Please answer the following questions, which will help determine whether or not you have maintained your lawful F-1 status and are eligible for the benefit of applying for CPT or OPT: I have not been employed off-campus without written authorization from the Designated School Official on my I-20, or an EAD from the United States Citizenship and Immigration Services (USCIS): qTrue qFalse I have not been employed on campus more than 20 hours per week while school was in session (fall and spring semesters): qTrue qFalse If the training is approved, I understand that I am responsible for maintaining my F-1 status. I will notify the Office of International Student and Scholar Services if I should move. I understand that CPT permission is given only for the employer below, and should I wish to make any changes to this training, I will receive authorization from the ISSS office. If I am applying for OPT, I am responsible for insuring that the employment is appropriate for my degree, as required by U.S. law. I hereby apply for a period of practical training. By signing my name below, I am certifying that the information provided on this form is correct, and that I have read the OPT or CPT Information Form and understand the duration and limitations of my training as it relates to my F-1 status. Signature__________________________________________________ Date:_______________ Printed Name_______________________________________________  ` CURRICULAR PRACTICAL TRAINING (CPT) Name of Employer_______________________________________________________________ Supervisor_____________________________________________________________________ Address of Employer_____________________________________________________________ Phone_____________________________ CPT Dates ______________ to ______________ Position Title and Description_______________________________________________________ ______________________________________________________________________________ q Full-Time (21 or more hours per week) q Part-time (20 hours or less per week) The training is: q Required for student s degree q Being taken for credit (course #________) Advisor Approval Student s Anticipated Graduation Date:_______________________ I have reviewed the CPT program outlined above. With my signature below, I certify that the employment is an integral part of the curriculum and is required for graduation or employment is being used for course credit . Signature______________________________________________ Date__________________ Name and Title_________________________________________________________________ OPTIONAL PRACTICAL TRAINING (OPT) Length of training: _______________ (12 month maximum) 9dejop) *  " $ 8 : ( * , οΝ}}}}qdqqhtV>*CJOJQJ^JhtVCJOJQJ^JhtVOJQJ^JhtVCJOJQJ^JhgOJQJ^JhtVOJQJ^JhOQCJOJQJ^JhtVCJOJQJ^JhtV5CJOJQJ\^JhtV5OJQJ\^JhtV htVCJ3jhOQhOQ5CJOJQJU^JmHnHu"9ep) * 8 :  ( , ^ $a$ ' ( *BD'IKL_`cտտտտղ藈޲q]޲&jhtVOJQJU^JmHnHu,jhtV5OJQJU\^JmHnHuhL5CJOJQJ\^JhtV5CJOJQJ\^JhLCJOJQJ^JhtV5OJQJ\^JhtV5CJOJQJ\htV5CJ\htV5CJ\htVOJQJ^JhtVCJOJQJ^JhtVCJOJQJ^J$ ' ( *D] JKMNOPQRSTgd3 & F$^a$$a$TUVWXYZ[\]^_c*+|}"#rsn`RTVnpT(+(>)?)P)v)w)))z*{*|*}*~*ȵȵȨȇ{țtph]X htV5\hICJOJQJ^JhtVCJOJQJ^JU htVCJhtV5OJQJ\^JhI5OJQJ\^JhI5CJOJQJ\^JhtVhtV5CJOJQJ\^JhtV>*OJQJ^JhtVOJQJ^JhgOJQJ^JhtVOJQJ^J'np78*(+(>)?)P))))Dates: from____________ to _____________ NOTE: Be sure to read the entire OPT information sheet that is attached to this form. If there is no sheet, you can obtain one from the ISSS office or our web site. Please keep in mind that it takes at least three months for OPT applications to be processed by the USCIS. Advisor Approval Students Anticipated Graduation Date: _______________________ With my signature below, I recommend that this student participate in OPT . 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