CPT Letter Request
Please fill in the form below. Please allow at least 2 business days for processing.
MIT ID
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Full Name
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First Name
Last Name
Pronouns
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E-mail
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example@example.com
Current Degree
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SB, SM, MST, MEng, PhD
Major Field of Study
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Faculty Advisor
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First Name
Last Name
Enrollment Start Date
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mm/dd/yyyy
Projected Enrollment End Date
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mm/dd/yyyy
Name and Address of Employer/Company
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CPT Start Date
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mm/dd/yyyy
CPT End Date
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mm/dd/yyyy
Description of employment
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How is this employment integrally related to your major field of study?
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Please identify specific subjects that you have taken that will support this internship and explain how they will support your work.
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Total number of units completed to date
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Will your CPT work be included in your dissertation?
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Please Select
Yes
No
Maybe
note: Undergraduates should always answer "no"
To qualify for CPT, the experience must either be NECESSARY for your thesis or coursework. Please indicate here how this CPT experience will be contributing to your degree
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Please indicate how many units of CPT you will register for (max. 3). Note that you will be charged tuition per unit.
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To receive credit for this internship experience you will need to submit some form of assignment be graded. Please briefly explain what that assignment will be (ex. a report, oral presentation, etc.)
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Name of Faculty who will Evaluate CPT Work
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First Name
Last Name
Additional Notes
Submit Form
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