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Counselor Student-Drop Form

Dear Counselor,

Complete this form to request a student to be dropped from the MICTED program. This form will immediately be emailed to MICTED to inform them of the change. Please know that once a student is dropped their seat is given to the next student in-line. If a student decides at a later date to re-enroll, they will need to do so by filling out a new application during open enrollment (March-August).

IMPORTANT: In addition to filling out this form, the student will need to ALSO disenroll from YC.

Please use this link to do so. (INSTRUCTIONS)

Thank you.

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Counselor's name*

Answer Required

Counselor's Email*

Answer Required

School's Name*

Answer Required

Student's Legal Full Name*

Answer Required

Program Student is Dropping*

Answer Required

I understand that this student will loose their spot in-line.*

Answer Required

Yes

I understand that this student is responsible for disenrolling from YC.*

Answer Required

Yes