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Student Withdraw Form

Please complete this form if you wish to withdraw from your current program.  After submitting this form, you must also complete the following steps:

  • Have a parent or guardian contact the MICTED district office at (928)771-0791 for information on filing the necessary ADE paperwork. 
  • Return all textbooks, supplies, and uniform items to the Mountain Institute District office or your high school CTE director. 
  • Most importantly, if you are concurrently enrolled in a YC class and it is not the end of the semester, you will need to log into your Yavapai College account and officially withdraw from classes.  Withdrawing from a concurrent or dual enrolled CTED program after the drop date may have serious consequences, including:
    • Receiving a failing grade or a “W” or “Y” on your high school and/or college transcript

    • Impacting your eligibility for future college or federal financial aid, which may affect your chances of getting into a university. 

    • Influencing re-admission decisions if you apply for another CTED program or for continuation of services

    • Losing high school credit, since all MICTED classes count as a full semester—if you withdraw early, you will not earn any high school credit for classes.

Directions on how to Withdraw from a Yavapai College course can be found HERE.  If you have any questions regarding this process, please reach out to our Associate Superintendent of Student Services, Shaun Rose at (928)771-0791 option 6. 

MICTED Program you wish to withdraw from*
Answer required for "MICTED Program you wish to withdraw from"
Confirmation Email