Honda International Center
Telephone: 734-9312
Email: hic@hawaii.edu
Curricular Practical Training (CPT)
Submit to HIC: This CPT form Original I-20 Letter from Employer Course Syllabus
This CPT satisfies a required:
Internship
Field Experience
Research Project
Fall
Spring
Summer
Course Title: __________________________
Year: ______
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Is this your last semester at KCC? Yes No
If “YES”, complete the following first:
Make sure that your I-20 end date matches your graduation date. If not, turn in your I-20 to HIC and
request for a shorten I-20 end date.
Submit a completed Reduced Course Load Form if taking less than 12 credits in your last semester
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Student Name: ___________________________
Supervisor’s Name: __________________________
UH ID #: ________________________________
Company Name: ____________________________
Address: ________________________________
Address: __________________________________
City: ______________ State: HI Zip: ________
City: ________________ State: HI Zip: ________
Phone Number: __________________________
Phone Number: _____________________________
Describe the proposed employment for Curricular Practical Training:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
You must specify the following in order for your application to be processed. The start and end dates listed on
this form must match the dates in your employer’s letter.
Start Date: ________________
End Date: _______________
Part-time (20 hours per week or less)
Full-time (over 20 hours per week)
OR
***IMPORTANT: YOU MAY NOT BEGIN WORKING UNTIL YOU RECEIVE YOUR WORK APPROVAL
FROM HIC. Failure to obtain approval prior to working is a violation of your F-1 status. It will take up to 5
business days to process your request.***
Student Signature: __________________________________________
Date: __________________
Please explain how this Curricular Practical Training is a required part of the coursework or assignment for the class.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Instructor/Advisor Name: _______________________________________
Signature:
Date: ________________
Rev 6-11