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Student Personal
Information
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Last Name * |
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| First Name * |
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Middle Initial |
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IIT Student ID# * |
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Personal Telephone * |
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| Personal Email * |
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Work Authorization
Information
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Work Authorization Status * |
U.S. Citizen
U.S. Permanent Resident
F1 Visa
Other (specify)
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SEVIS ID#(if applicable) |
N |
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Student Academic
Information
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Campus * |
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Degree * |
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Major * |
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Academic Advisor * |
Note: Academic advisor
is different from CMC advisor. Academic
advisor is usually a professor in
your academic department.
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GPA * |
My
GPA is above 3.0 and I am eligible
for co-op
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Expected Graduation Date * |
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Employment Information
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I confirm that the employment listed
below will be taken for one of the
following reasons: * |
To supplement coursework.
Mention course(s):
To assist in research/thesis/preparation
for qualifying exams
To enhance current coursework with
practical application
To fulfill program/course requirements.
Mention course(s):
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Company Name * |
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Company Department * |
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Company Address |
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Street Address #1 * |
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Street Address #2 |
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City * |
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State * |
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Zip code * |
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Job Title * |
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| Job Description |
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Work Location Address (if different
from above) |
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Street Address #1 |
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Street Address #2 |
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City |
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State |
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Zip code |
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Work Telephone * |
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| Work Email * |
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Co-op Renewal
Information
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Dates of most recent co-op term
completed |
From *
To *
Note: If you are an International student, these dates can
be found on the last page of your
I-20. |
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Co-op renewal term |
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Co-op renewal dates |
From *
Your start date must be at least
5 days from today. International
Students, you can not resume working
until you have received your I-20
from the International Center.
For Main Campus
To *
Note: The end date is July 26, 2008 by default.
If you would like to continue working past July 26, 2008 and you are not planning on working during fall semester,
you must complete the Online Extension Form, which will be available on the CMC website on Monday, July 7.
If you are going to continue working in a co-op during fall semester, you will need to renew your co-op by July 21 to get a July 28 start date.
Please contact your CMC Advisor with any questions.
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For Downtown Campus
Note: These dates are
for Stuart students for the Spring
term Co-op. To enable this field
select "Downtown Campus" from above
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Number of hours per week * |
Full-time (more than 20 hours/week)
Part-time for
hours/week
Note: Part-time co-op
hours combined with any on-campus
employment should not exceed 20
hours/week |
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I-20 pick up location * |
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Comments |
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International students, please
read following instructions
before you submit
- The International
Center will take this form prior
to the co-op deadline.
Check co-op
deadline. Please note that
you must submit the renewal
for CPT 7 days before your current
CPT expires if you wish to work
continuously.
- You must
complete your degree by the
expiration date indicated on
your I-20. The International
Center will not be able to extend
I-20's beyond the expiration
date if off-campus employment
(CPT) has been authorized. It
is your responsibility to schedule
your required courses with CPT
in order to graduate on time.
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