Summer/Fall 2022

Religious COVID-19 Exemption Request Form- Students

Student name*
Do you regard yourself as having a sincerely held religious belief, practice or observance that you believe should exempt you from the COVID-19 Vaccination Requirement?*
Decisions on Religious Exemption Requests will be decided on a case by case basis. Religious beliefs do not have to be theistic, but can be non-theistic, strongly held moral or ethical beliefs. However, mere personal preferences - - beliefs based on social, political or economic philosophies, or veganism, for example - - are not considered religious beliefs. Students who hold a sincerely held religious belief will be engaged in an interactive process and accommodated, absent an undue hardship to the College.
Have you previously received a vaccination of any kind after the age of 18 (e.g. vaccination(s) for Influenza (the “flu”), Hepatitis A, Hepatitis B, Tetanus, Measles, Chicken Pox, Polio, Yellow Fever, Human Papillomavirus (HPV), Tuberculosis, Shingles, Typhoid, etc.)?*
Provide below or attach any additional information supporting your religious accommodation request, including, but not limited to: Articles from religious scholars that describe the nature of the religious belief(s), practice(s), or observance(s); Excerpts from religious or sacred texts explaining the religious belief(s), practice(s), or observance(s); or Written materials that describe the religious belief(s), practice(s), or observance(s) that prohibit vaccination.
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Dean's Decision

Dean's Decision*
Reason for Decision