Mason City Community School District

Attendance Boundary Exception Grade K-8 Request

PLEASE COMPLETE ONE APPLICATION PER FAMILY

Answer all that apply. Note that Neighborhood school is the school the child would be attending based on current address. The exception school is the school you would like your child to attend.
Please indicate the school year for which transportation is requested. School Year
(School year begins in fall and ends in spring)

Name of Parent/Guardian:
 
Home Street Address:
(No PO Box - Need Street Address) 		Home Phone:
Student(s) Full Name Gender Grade Neighborhood School: Exception School:


Please indicate below the reason(s) for the exception.

Daycare
    (Provider's Name) (Provider's Address)
Previous Boundary Exception
    (Previous Exception School) (Previous Exception Year)
Moving into area
    (Please indicate approximate date of move)
To finish current school year
    (Comment)
Special Education Planning
    (Comment)
Other
    (Comment)


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