CPT Request Form

By filling out this form, you are stating that you understand that the purpose of CPT is to allow the student to fulfill internship or praacticall training requirements for their degree. It is not to be used for employment purposes. You also understand that the ISR Office will evaluate and authorize or deny this CPT form. The ISR Office retains full discreation to authorize or deny this CPT request in accordance to federal regulations and policies.

Name Name First Last
ORU Z number
Email
Major
Student level
CPT start date CPT start date / MM / DD YYYY
CPT end date CPT end date / MM / DD YYYY
Indicate if CPT is full time or part time

Indicate if CPT is full time or part time Part time Full time
Upload a copy of your academic advisor's authorization

Attach Files
Indicate which class(es) this CPT is required for
Upload a copy of your employer's authorization

Attach Files
By checking "I agree", you are acknowledging that you have carefully read ORU's CPT policy as explained on the ORU website, and agree to abide by it. You further acknowledge that any violation of CPT policy will result in immediate F-1 visa termination.

By checking "I agree", you are acknowledging that you have carefully read ORU's CPT policy as explained on the ORU website, and agree to abide by it. You further acknowledge that any violation of CPT policy will result in immediate F-1 visa termination. I agree
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.