Religious Observance Request Form

"*" indicates required fields

Name *

First Last

Email *

School and Program/Major *

Pharmacy and Health Professions students must submit a copy of this form, once approved, to whomever grants excused absences within your respective school.

Year of Graduation *

Course Affected by Request *

Your Professor's Email Address *

What is the date, time, and location of the religious observance for what you are seeking accommodations? *

State how the religious observance conflicts with your academic schedule and what specific accommodations you are requesting. *

By checking this box, you also understand that the accommodation may not be granted, but that Shenandoah University will do its best to provide a reasonable accommodation to you. *

Yes, I understand.

No, I decline.

Name

This field is for validation purposes and should be left unchanged.