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CPT Student Approval Form

This form provides the MSSIS Office with information required to grant "CPT" work authorization to an international student in F-1 visa status. For all students the academic advisor or Department Head must complete the following CPT Student Approval Form.


Curricular Credit For the Internship: In order for the student to qualify for curricular practical training, the student Must either get credit in a course (such as an internship course or an independent study) or the work Must be required for the degree.

Student Requesting CPT Approval (Last name, First name) (*)

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Student CWID (*)

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The Student Will Earn Credit In A Course? (*)

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Course Title & Number (ex. BADM 401) (*)

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Number of Credits Student Will Receive (*)

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Semester & Year the Student Will Take the Course (ex. Spring 2014) (*)

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The Work Is Required for the Student's Degree Program? (*)

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The Degree Level & Field the Student is Pursuing (B.S.-Business Administration) (*)

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By completing the questions below, I, as the student’s Academic Advisor or Department Head understand the eligibility requirements for CPT and hereby certify that to the best of my knowledge the above information is accurate.

Last Name, First Name (*)

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CWID # (*)

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Phone Number (*)

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Position Title (*)

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