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F-1 CPT Request

This web form is to be used by eligible Dartmouth College-sponsored F-1 students only, to apply for Curricular Practical Training (CPT).

For all CPT applications, we will need the following, in addition to this web form:

1. A copy of your current passport ID page, and renewal page if applicable
2. A copy of your current I-94 card, front and back
3. A letter signed by your CPT employer on their company letterhead that includes:
   • Job or training title
   • Wage or compensation amount
   • Start and end date of employment
   • Location of employment (actual physical address with zip code)
   • Supervisor's name

You may scan all the required copies listed above into one pdf file and email it to OVIS@Dartmouth.edu.

General Information

Who is your immigration advisor at Dartmouth College? (ie. Susan Ellison, Ken Reade, Marcia Calloway):

First or Given Name:

Last or Family Name:

Date of Birth (mm/dd/yyyy):

SEVIS ID # (found above the barcode on your Dartmouth College I-20 form):

Residental Address

Address Line 1:

Address Line 2:

Address Line 3:

City:

State:

Zip:

Phone:

Email Address:

Current Mailing Address

Address Line 1:

Address Line 2:

Address Line 3:

City:

State:

Zip:

Phone:

Degree Program you are completing (ie. BA/BS, BE, MA/MS, MEM, MBA, MALS, MPH, MD, PhD, MD/PhD, MD/MBA, or other):

Degree Program of Study (UGs please indicate Liberal Arts):

Major:

Second Major:

I am applying for (please indicate full-time or part-time CPT):

This internship qualifies for CPT based on the following reasons. Please select one from the list below:

My degree program requires an internship from all students.
I am enrolling in a course for academic credit that requires a work experience.
Other (please contact your immigration advisor with details)

Professor's Name:

Course number:

Course Name or Title:

Term in which the course will be taken:

Date academic program will end (This is the date after which you have no obligation to the school, in order to get the degree. This is your graduation date, the date of your last exam, or the date you submit your thesis, whichever is **earlier**) (mm/dd/yyyy):

Date you wish to be able to begin working under CPT (mm/dd/yyyy):

Date your CPT will end (mm/dd/yyyy):

Employer and Job Information

Supervisor's Name:

Supervisor's Title:

Employer/Company/Organization Name:

Street Address (location where you will be working)

Address Line 1:

Address Line 2:

City:

State:

Zip:

Company Telephone #:

Supervisor's Email Address:

CPT Applicants:
Please submit a pdf file containing copies of your passport ID page, your most recent I-94 card, and a copy of the required letter from your faculty supervisor or academic program director. Please email these documents to OVIS@dartmouth.edu

Click "Submit" below to send your CPT application to the Office of Visa and Immigration Services (OVIS), Dartmouth College.