Cpt (Co-Op And Internship) Form For Cps International Students


ISSI Form 165
CPT (Co-op and Internship) Form
for CPS International Students
Who should complete this application?
All international CPS students who intend to participate in a co-op or internship (paid or unpaid, full or part-
time, out-of-state or international placements).
How do I complete this application?
This form is divided into three parts. Part 1 must be completed and signed by the international student; Part 2
will be completed and signed by the student’s CPS CPT Advisor; Part 3 will be completed and signed by the
DSO for international students at the ISSI.
Is there anything I should know before completing this application?
The student cannot engage in CPT until s/he receives written authorization from the ISSI, and may work
only within the dates specified on the documents that s/he will be issued. Working without first obtaining
authorization from the ISSI may result in the student’s loss of legal status in the U.S.
Where do I submit this application?
Please submit this application (no copies or faxes) to the ISSI at 405 Ell Hall.
What else do I need to submit with this application?
Please submit your passport, visa, I-94 card and current I-20/DS-2019 form, copies of which will be needed for
your CPT application.
International Student & Scholar Institute
405 Ell Hall,
Phone: 617-373-2310 Fax: 617-373-8788
ISSI 165-MB-22409 [Q] W


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