CPT Authorization Request Form

CPT Authorization Request Form
Student Information
Name

First NameLast Name
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
Please enter a valid email address.
Date of Birth

MonthDayYear
Date
Year of CPT Applying
Quarter of CPT Applying (applying quarter 2026 Spring)
Degree and Major
SEVIS ID #
10 digits Including N

Company Information
Official Employer/Company Name
Starting & End Date Information

Must follow the information below on your document!!

Starting Date: July 06 , 2026

End Date: Oct 04, 2026
Employment Start Date

MonthDayYear
Date
Employment End Date

MonthDayYear
Date
Hour per Week
Job Position
Explain how your job position is related to the major of your study(business).
Employment / Company Address

Street Address

Street Address Line 2

CityState

Zip Code
Address where work will take place (If different than above)

Street Address

Street Address Line 2

CityState

Zip Code
Name of Manager

First NameLast Name

Curricular Practical Training (CPT)

CPT Processing Fee (0.5-unit course)

$75.00 Quantity

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Job Offer Letter

Please refer to the example
Cancelof
IMPORTANT NOTE

We will review your CPT request and Job offer letter, including your Attendance and Grades, to ensure they meet the required regulations.

Make sure to follow the CPT offer letter guidelines (refer to the sample job offer letter on our website). If any required information is missing, you will need to resubmit the letter.

It is your responsibility to follow SEVIS and CPT guidelines.

If all criteria are met, we will send you an approval notice via email. Please be patient, you can expect to receive an email from us in the next few days.
Signed Date

MonthDayYear
Date
Signature
Should be Empty: