Request for Religious Accommodation

INSTRUCTIONS | STUDENT INFORMATION

GENERAL INSTRUCTIONS:


To request any religious accommodation, we encourage you to submit this form to each course instructor and/or campus employment supervisor no later than the the last day of the 4th week of classes (see Academic Calendar) or within 2 weeks of the requested accommodation, to the best of your ability (especially if your accommodation is needed within the first 4 weeks).We encourage submission of the form at the earliest opportunity to reach an optimal accommodation. Refer to this list of Religious Holidays for this Academic Year.


STEPS FOR REQUESTING RELIGIOUS ACCOMMODATION:

  • We encourage you to complete this form no later than the current semester’s last day of the 4th week of classes or within 2 weeks of the requested accommodation, to the best of your ability. We encourage submission of the form at the earliest opportunity to reach an optimal accommodation. Please list EACH course instructor and/or campus employment supervisor.
  • Save and download a PDF version of the completed form.
  • Email the PDF to EACH course instructor and/or campus employment supervisor.
  • Expect a response from the course instructor and/or supervisor within two weeks of emailed request.
  •  If you do not receive a response within two weeks, or you would like to appeal the decision made, contact the course instructor and/or department chair. You can also seek the support of your academic adviser.


Excused absences from classes or examinations for religious observances will not be counted against any mandatory attendance requirements, but they do not relieve students from responsibility for any part of the coursework required during the period of absence. The instructor may appropriately respond if the student fails to satisfactorily complete any alternative assignment or examination. For more information, refer to University Policy 409 (UC Berkeley’s policy regarding the Religious Accommodation for Students).

First and Last Name of requestor
Cal Student ID Number
Provide your official .berkeley.edu email address and a phone number you can be reached at
Are you asking for an accommodation as a student, student employee, or both?
NOTE: You must fill out both "For Students" and "For Student Employees" sections if you checked "both"
If your Religious Affiliation/Faith is not on this list, you may provide additional information here

Use the field below for special circumstances that require a religious accommodation outside of a traditional course structure (or courses beyond 5):