Curricular Practical

**How to submit completed application (this form and job offer letter):** Training (CPT) Application
1. During walk-in advising hours OR
2. E-mail to your full-time IO Advisor Updated 5/2018

This form is required before any off-campus opportunity can be authorized for CPT.
Note: CPT is authorized on a quarter-by-quarter basis. The student should fill out the top portion and then meet with one of the
following NU staff (academic advisor, thesis/dissertation advisor, McCormick Career Office advisor, program director, or Chicago
Field Studies advisor) for his/her signature.
STUDENT INFORMATION

Family Name: First Name:

SEVIS ID: Student ID: 1st Quarter/Semester at NU:

Degree level: Major: Minor:

OFFER INFORMATION - Must match offer letter exactly

Name of Company/Institution:

Site of Activity (Complete Address):

Start Date: End date:

I am requesting: Full Time (21 hours per week or more) Part Time (20 hours per week or fewer)
ACADEMIC NECESSITY
Identify which class you will be or are registered for that necessitates CPT.
Option 1: Work is needed to fulfill requirements for an established course

Click to choose course If other, list course:

*for Undergraduates ONLY* - if course is listed in "other" and taken in quarter directly
proceeding or will be taken following work experience, indicate the quarter of enrollment.

Option 2: Work is part of an established co-op, clinical training program or other required training program

Click to choose course If other, list course:

Option 3: Graduate student who is registered for thesis, dissertation, or continuation courses and the work is necessary
for the completion of the thesis, dissertation, or degree.

Click to choose course If other, list course:

NU VERIFICATION
If the student indicated 'other' above, please explain how the course indicated and the associated CPT is an integral or required
part of the student's program of study below:

By signing below, I also confirm that the above named student is currently enrolled as full-time and is in good academic standing.

Name: Title:

Signature: Date:

Northwestern University - The International Office IO USE ONLY

630 Dartmouth Place, Evanston, IL 60208-2147
Date received: ____________
Ph: (847) 491-5613 - Fax: (847) 556-6006
www.northwestern.edu/international - intoff@northwestern.edu
Pick up on : ____________
Advisor initials: ____________