Form 110: Off-Campus Internship & Curricular Practical Training (CPT)
Instructions and Application for International Students
For all current F-1 international students wishing to work or do an off-campus internship, or
Curricular Practical Training (CPT), please note the following eligibility guidelines:
o Student must have completed 57 credits or more, including credits transferred in.
o Student must have been in status for at least 2 academic semesters.
o All international students must receive academic credit for their internship, per F-1
student federal regulations. Please note that Westminster College does charge a fee ($250
per credit hour) for credit-bearing internships over the summer.
o Job or internship must be related to your academic area of study.
To apply for CPT work authorization, interested students should contact the Internship Coordinator in the
Office of Career Services and then consult with the Director of International Student Services. Students
must complete this Form 110 in its entirety to be authorized for CPT employment. There is NO fee
required for CPT.
Additional CPT Information
An F-1 visa holder can complete a total of 11 months of full-time work on CPT. Surpassing 11
months will jeopardize your ability to do an OPT post-graduation through Westminster. Part-time
work (under 20 hours/week) does not count towards this total.
All international students must receive authorization from the DSO (Designated School Official, in
this case the Director of International Student Services) prior to beginning any off-campus
employment. Students working off campus and without prior authorization are considered to be out
of status and as a result their F-1 status may be terminated.
Your proposal must be approved by the Office of International Student Services and the Internship
Program in order to receive authorization. These offices reserve the right to not approve an
incomplete or insufficient application. If approved, the DSO will create and print a new I-20
document for you with CPT authorization noted on Page 3.
These guidelines are unique to CPT. Any student wishing to receive OPT (Optional Practical
Training, a one-year employment benefit usually used following graduation) should meet with the
Director of International Student Services. A special application process must be followed and
requires the assistance of the Director of International Student Services.
To assure everything goes smoothly, please follow the below steps:
1. ____ Meet with the Internship Coordinator to discuss employment options. To schedule an
appointment call x5382 or email firstname.lastname@example.org
2. ____ Work with Career Services to find and secure an employment opportunity.
3. ____ Complete the attached form. Obtain the signatures of your faculty sponsor and site
supervisor and submit the completed form to the Internship Office for approval. If
you have an issue obtaining the necessary signatures, contact Abigail or Courtney.
4. ____ Prior to beginning employment, meet with the DSO to receive a new I-20 with
employment authorization. NOTE: Please retain ALL copies of I-20’s.
FORM 110: Internship Information for International Students
* means Required information
*Name: ________________________________________ Date of Birth: __________________________________
*Credit Hours Completed (including credits transferred in): ________________ Campus box: _______________
*Major(s): ______________________________________ Minor(s): ______________________________________
Phone: ___________________________ WC e-mail: __________________________________________________
Mailing address during internship: __________________________________________________________________
NOTE: CPT internships must be FOR CREDIT; please complete the line below and obtain faculty sponsor approval:
*Number of credits ______ __ __ __ 399: __________________________________________________Internship
(1 cr = 50 hrs on site) Dept. Course Title (must be no more than 28 characters, including “Internship” and spaces)
*Faculty Sponsor Approval (Note: Faculty Sponsor must have expertise in the dept. through which you are seeking credit.)
Sign: ______________________________________________ Print Name: ________________________________
*Term (ex. Fall 2011):_______________ *Start Date: ____________________ *End Date: _____________________
Hours to work per week: ________________ Site work schedule, if known:
M: _________ T: __________ W: _________ Th: _________ F: __________ Sa: __________ Su: __________
Is the position paid? ____ No ____ Yes ____________________ Amount
*Part-time (up to 20 hours / week) OR *Full-time (over 20 hours / week)
Site Supervisor Information:
*Name: Dr. Mr. Ms. _________________________________ *Title of Supervisor: _____________________________
*Street Address: ___________________________________________________________________________________
*City: __________________________________________ *State: ____________ *Zip: ____________________
*Phone: ________________ Fax: _____________________ e-mail: ____________________________________
*Site Supervisors Signature: __________________________________________________________________________
*NOTE: This information must be completed to receive the required work authorization from the campus DSO. Employment is job
specific. Please complete Page 2.
FORM 110: Page 2
Please answer the following questions. Use additional paper if necessary.
*Highlight your duties and responsibilities in your proposed internship position:
*Describe how the proposed employment relates to your planned field of study or major:
Student’s Signature: ______________________________ Date: ______________
Return to: Internship Coordinator, Westminster College
501 Westminster Avenue, Fulton MO 65251-1299
Phone: (573) 592-5382 Fax: (573) 592-5383 E-mail: Abigail.Manwell@westminster-mo.edu
Web site: http://www.westminster-mo.edu/studentlife/career/internship/Pages/default.aspx
Office use only: Reviewed by: ______ Date: _________ Approval? Y / N Reviewed by ISS ______ Approval? Y / N