Va Religious Exemption Form

Religious Exemption Form Ct Fill Out and Sign Printable PDF Template

Va Religious Exemption Form. The student or his parent or guardian submits a notarized certificate of religious exemption (form cre 1), to the admitting official of the school to which the student is seeking admission. Fully vaccinated (required documentation attached):

Fully vaccinated (required documentation attached): Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Web employees should provide this form to the rac. You may select medical exception, religious exception, or select both if you meet the criteria for both a medical and religious exception. Web form prior to submission to your supervisor. Check one statement below and complete and sign the last section of this form prior to submission to employee occupational health: Web regarding disability requests, approvals will be annotated on both the va form 10230a and va form 0857f, accommodation request determination, in accordance with va handbook 5975.1. Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Form cre 1 is an affidavit stating that the administration of immunizing agents conflicts with the student's religious tenets or practices.

Please read the descriptions below to learn the criteria to request a medical or religious exception. Web commonwealth of virginia certificate of religious exemption name ____________________________________ birth date _______________________ student i.d. Trainee, resident, intern, fee basis, or researcher) please indicate: Check one statement below and complete and sign the last section of this form prior to submission to employee occupational health: Regarding religious requests, approvals will be annotated on va form 10230b and written notice of the approval I have read and fully understand the information on this form and have been given the opportunity to have my questions answered. Number __________________________________ the administration of immunizing agents conflicts with the above named student's/my religious tenets or. Fully vaccinated (required documentation attached): Rac will assign log number below for record keeping purposes. This form should be retained separately from the employee's official personnel folder. The student or his parent or guardian submits a notarized certificate of religious exemption (form cre 1), to the admitting official of the school to which the student is seeking admission.