Denver Seminary

Curricular Practical Training (CPT) Request Form Required to Report While on CPT, you are required to report, in writing and within 10 days of change, the following information to a DSO: 1 ) Change in your legal name 2 ) Change in your U.S. home address 3 ) Changes in employment or interruption of employment Student Contact Information: S tudent I D : T oday's D ate: / / L ast Name: Middle Name: First Name: Z IP: State: City: Current Address: Address while on CPT: s ame as above I do not know yet m y new address will be: Z IP: State: City: Street Address: CPT Types and Eligibility: W hat type of CPT are you applying for? P art-Time CPT (less than 20 hours per week) F ull-Time CPT (more than 20 hours per week, NOTE: engaging in 12 or more months of full-time CPT will make you i neligible for OPT) H ave you completed one year of your (degree-seeking) program prior to the anticipated start of your PT? Y es N o H ave y ou e ver p articipated i n C PT, w hether a t D enver S eminary o r t hrough a ny o ther i nstitution? Y es N o I f y our a nswer i s y es, p lease d escribe y our C PT e xperience: S tart d ate o f p revious C PT: E nd d ate o f previous C PT: W as this CPT part-time or full-time? ___________________ / year: /date: month: What is your preferred start date for your CPT?* *Your official start date will be assigned by your DSO once your CPT is officially authorized. You are not allowed to begin working until the official s tart date indicated on your new Form I-20. A full review of CPT options and regulations can be found on www.ice.gov. Please read and familiarize yourself with these regulations and the timeline of your required next steps prior to completing this form. You must submit this completed application to your DSO prior to your preferred CPT start date to be considered for work authorization under CPT. Student Care Specialist: 303-357-5833, 6399 S. Santa Fe Dr. Littleton, CO. 80120 studentcare@denverseminary.edu FAX: 303-783-3122

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