Last Name:* Preregistration Number (6 digits):* Course Title:* Course Number:* Course Section Number:* Home Institution:* Originating Institution:* Student Authorization:* Session:* Protection Code:* Please, enter the text shown in the image into the field above. captcha code reload Email:* Last Date Attended or Effective Date: date selector Middle Name: First Name:* ICN Online Drop/Withdrawal Form Click to refresh the text Student Signature: enter your first and last name Date:* Email used for ICN Registration e.g. Summer 2012 Before you drop or withdraw from a course, contact the ICN campus coordinator at your Home Institution for a copy of the refund policy and drop schedule. Your ICN campus coordinator will notify your instructor. Note, this form processes one course at a time. Misc. Info: