Form I-538 - Certification By Designated School
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2OMB Approval No. 1115-0060
U.S. Department of Justice
Certification by Designated School
Immigration and Naturalization Service
SECTION A. This section must be completed by the student, as appropriate. (Please print or type):
1. Name:
(Family in CAPS)
(First)
(Middle)
2. Date of birth:
3. Student admission number:
4. Date first granted F-1 or M-1 status:
N/A
5. Level of education being sought:
6. Student's major field of study:
7. Describe the proposed employment for practical training:
Request CPT in the field of
Beginning date:
Number of hours per week:
Ending date:
8. List all periods of previously authorized employment for practical training:
A. Curricular or work/study:
B. Post completion of studies
Signature of student:
Date:
SECTION B.
This section must be completed by the designated school official (DSO) of the school the student is
attending or was last authorized to attend:
9. I hereby certify that:
The student named above:
Is taking a full course of study at this school, and the expected date of completion is:
Is taking less than a full course of study at this school because:
Completed the course of study at this school on (date):
Did not complete the course of study. Terminated attendance on (date):
Check one:
A. The employment is for practical training in the student's field of study. The student has been in the educational program for at
least nine (9) months, is in good academic standing, and is eligible for the requested practical training in accordance with INS
regulations at 8 CFR 214.2(f)(10). The training that the student will participate in is an integral part of an established curriculum.
B. The employment is for an internship with a recognized international organization and is within the scope of the organization's
sponsorship. The student is in good academic standing.
10. Name and title of DSO:
Signature:
Date:
11. Name of school:
School file number:
Telephone Number:
For Official Use Only
Microfilm Index Number:
(See instructions on reverse)
Form I-538 (Rev. 08/12/02)Y
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