EOA - Religious Reasonable Accommodation Request Form

In accordance with federal and state laws and Vanderbilt University policies,
Vanderbilt University prohibits discrimination on the basis of religion.
Vanderbilt provides reasonable accommodation for a person’s sincerely held
religious/personal beliefs or practices unless the accommodation would
impose an undue hardship on Vanderbilt. A reasonable religious
accommodation is any adjustment to the work and/or academic environment
that will allow the individual to practice his/her religion.

In general, an employee should inform his/her supervisor that he/she
needs a religious accommodation. An employee should notify management
as soon as he/she becomes aware of a need or potential need for
accommodation. Vanderbilt is not required to provide an
accommodation if is not aware of the individual’s need and
desire for accommodation. Reasonable accommodations are
determined, identified, and implemented using a collaborative process.
Contents of this request are confidential and will only be shared with
appropriate personnel to consider the implementation of a reasonable
accommodation. This form will not be placed in employment records.
The information may be released to external agencies.

Equal Opportunity & Access Office (EOA)
Loews, Suite 780
2100 West End Avenue
Nashville, TN 37203
or fax to (615) 343-4709
phone (615) 343-9336

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Part I

(Part I is to be filled out by the person requesting a religious reasonable
accommodation and submitted to EOA.)
Initial Request Renewal Request
EMPLOYEES ONLY
Name: Name: First Last
Title/Position:
Department:
Phone Number: Phone Number: - ### - ### ####
Email address:
Immediate Supervisor:
Supervisor’s phone number: Supervisor’s phone number: - ### - ### ####

EOA - Religious Reasonable Accommodation Request Form

EOA - Religious Reasonable Accommodation Request Form

Part I

EMPLOYEES ONLY