Request for Religious Accommodation

The University is committed to providing an academic and work environment that is respectful of religious beliefs in accordance with state and federal laws and regulations. This commitment includes embracing religious diversity and cultivating a community of inclusion and respect. Reasonable accommodations will be provided to individuals whose sincerely held religious beliefs conflict with a University policy, procedure, or other academic or employment requirement, unless it is determined that doing so would cause undue hardship to the University.

Please complete the information below to request a religious accommodation.

Religious Accommodation Form

Affiliation

What is your Affiliation? (Required)

Employee

Student Employee

Student

Prospective/Entering Student

Applicant for Employment

Beneficiary of University Program

Requestor Information

Name (Required)

Position Title (If Applicable)

Department/Program Name (Required)

Immediate Supervisor (If Applicable)

Supervisor's Phone Number (If Applicable)

Employee or Student ID Number (If Applicable)

E-mail (Required)

Contact Number (Required)

Accomodation Request

Please describe the religious belief, practice, or observance that is the basis for the requested accommodation. (Required)

What work or academic requirement interferes with the religious belief, practice, or observance previously described and explain the nature of the conflict. (Required)

Please describe the specific accommodation(s) being sought, including an explanation of how it would enable you to meet your religious obligation without impacting your ability to meet the required/essential elements of your work or academic requirement. (Required)

Please provide any additional information that might be relevant in processing your religious accommodation request.

Employees only: Please specify whether applicable paid leave will be taken due to the observance of a religious holiday.

I verify that the above information is complete and accurate to the best of my knowledge and I understand that any intentional misrepresentation contained in this request may result in disciplinary action. I also understand that my request for an accommodation may not be granted if it is not reasonable or if it would impose an undue hardship on the University/employer (Required)

Date (Required) (Select today's date)

Supporting Documentation

Office of Human Resources

Request for Religious Accommodation

Religious Accommodation Form

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