Page 34 - Religous Liberty Kit

30 Sample Language for Requesting a Religious Accommodation or Exemption

Sample Language for Requesting a Religious
Accommodation or Exemption

Below we have included some sample language that
others we have worked with have used successfully to
request a religious exemption or accommodation.

• Sample A is a general request for a religious
accommodation based on Christianity.

• Sample B is a request for an accommodation focused
on the teachings of the Catholic church and includes
an accompanying essay by Father Kevin Flannery, S.J.,
“Avoiding Illicit Involvement with Evil.”

• Sample C is a request for an accommodation focused
on the teachings of Islam provided to us by
Dr.Abdullah bin Hamid Ali, Associate Professor of
Islamic Law at Zaytuna College.

• Sample D is a military exemption request for religious
accommodation form.

If any of the sample language reflects your sincerely held
Sample Language religious beliefs, please reword the sample into your
own words. (We are sharing this sample language with
for Requesting numerous people and suspect that employers may be
a Religious more receptive to a request that they can tell reflects an
employee personal thoughts and is not simply a “cookie-
Accommodation or cutter” request.)
Exemption SAMPLE A –

Protestant/General Christian Exemption Request

I am seeking a religious accommodation from ________’s
COVID-19 vaccine requirement because of my sincerely
held religious beliefs. In 1 Corinthians 6:19-20, the Bible
commands Christians to honor God by caring responsibly
for our bodies as temples of the Holy Spirit. I believe
that receiving any COVID-19 vaccine would violate the
Bible’s command to honor God with my body because
of the involvement of fetal stem cell lines in the COVID
vaccines’ development (Johnson & Johnson) and
testing (Moderna and Pfizer). See David Prentice, Ph.D.,