Curricular Practical Training Application

To obtain authorization for Curricular Practical Training (CPT), please follow these steps:

Complete the form below. Submit it using the "Submit" button at the bottom.
This form is for undergraduates only.
After I have signed the form electronically, I will forward a copy to you. .
You should then receive then register for 1 unit of CS197 using the CCN on the confirmation to your submission.
If you are an international student needing work authorization: Print proof of registration and take it with the completed form to the Berkeley International Office so they can process it.

N0000000000

At the end of your internship, complete a 4-page paper illustrating your internship experience, what you learned, how it compared to what you're learning here in CS, etc. and submit it electronically using this link. no later than the last day of lecture.

Application Form

Personal information

First name	Last name (family name, surname)
Student ID Number	SEVIS ID Number
Telephone	Email
Major/Department	Your expected graduation date

Employment Information Job Title

Company Name

Part-time (20 hours/week or less) Full-time (more than 20 hours/week)

Is your supervisor an F-1 or J-1 student? Yes No

	mm/dd/yyyy		mm/dd/yyyy
Start Date:		End Date:
Must be on or after first day of semester		Must be before start of next semester

Paul N. Hilfinger
Hilfinger@CS.Berkeley.EDU

Page last modified on Wed Nov 27 13:29:40 2019.