Denver Seminary

Curricular Practical Training (CPT) Request Form Name of Employer (name of church, organization, company): Employer's Address: State: City: ZIP: Name of Supervisor: Supervisor's Phone Number: Is this a paid position (either salary or hourly)? Your Job Title: Yes No Will you be working part-time or full-time? Part-time (20 hours or less) Full-time (20 hours or more) Explain how the employment will be related to your Denver Seminary course curriculum: _ ______________________________ _________________________________________________________________________________________________________ Employment start date: _/ / Employment end date: / / Recognition of Responsibility In completing and signing this request form, I agree to fully comply with all immigration regulations which apply to me as an F-1 student. I acknowledge that this CPT application is only valid for one semester of CPT authorization, and I must complete the process again for each subsequent semester that I wish to participate in CPT. I understand that I must comply with all employment regulations and that working without the proper authorization is a serious violation of my nonimmigrant status in the U.S. If I fail to comply with my responsibilities, I acknowledge that I may not be eligible for benefits normally granted to F-1 students and I may put my stay in the U.S. at risk. Signature Date Next Steps Completed CPT applications must be submitted to your DSO and approved prior to beginning employment. After this form has been received and processed by a DSO, a new Form I-20 will be created for you. This I-20 grants your work authorization for CPT and will be used by your employer for documentation of your work authorization. You may not begin working until you have received your new Form I-20 and your work authorization has been completed in SEVIS by your DSO. You may not begin working until the start date on your new Form I-20. You must have an offer of an employment that qualifies for CPT to apply for CPT. Please attach a copy of your formal employment offer letter on organization-specific letter head. Your employment offer letter should include 1) your employer's name and address, 2) your employment start and end dates, 3) your expected work hours, 4) the financial compensation you will earn, and 5) a brief description of how your position and work are directly related to your course curriculum. This letter should be signed and dated by both you and your employer. You must also be registered for a course for which your employment is an integral part of the course curriculum. Please attach the syllabus for the specific course for which you are registered that will be linked to your CPT. Student Care Specialist: 303-357-5833, 6399 S. Santa Fe Dr. Littleton, CO. 80120, studentcare@denverseminary.edu FAX: 303-783-3122 Employment Information:

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