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Page 1 of 4 THE UNIVERSITY OF THE STATE OF NEW YORK THE STATE EDUCATION DEPARTMENT REQUEST FOR RELIGIOUS EXEMPTION TO IMMUNIZATION FORM PARENT/GUARDIAN STATEMENT Name of Student Identification Number

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What is request for religious exemption?

A request for religious exemption is a formal application to be exempted from certain religious requirements or obligations based on the individual's sincerely held religious beliefs.

Who is required to file request for religious exemption?

Any individual who wishes to be exempted from religious requirements or obligations based on their sincerely held religious beliefs is required to file a request for religious exemption.

How to fill out request for religious exemption?

To fill out a request for religious exemption, the individual should provide their personal information, including name, contact details, and any relevant religious background. They should also clearly state the specific religious requirement they are seeking exemption from and provide a detailed explanation of their sincerely held religious beliefs.

What is the purpose of request for religious exemption?

The purpose of a request for religious exemption is to allow individuals to exercise their freedom of religion by seeking relief from specified religious requirements or obligations that conflict with their sincerely held religious beliefs.

What information must be reported on request for religious exemption?

A request for religious exemption should include the individual's personal information, a clear statement of the specific religious requirement they seek exemption from, and a detailed explanation of their sincerely held religious beliefs that conflict with the requirement.

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