Request for Religious Exemption to Immunization
This form is essential for students seeking a religious exemption from immunizations at Pace University. It outlines the necessary criteria and provides guidance on how to complete the request. Ensure you have a firm understanding of your religious beliefs before submitting this form.
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How do I fill this out?
To fill out the request for a religious exemption, first ensure you have a clear understanding of your religious beliefs regarding immunizations. Next, type or hand-write your responses in the designated fields provided on the form. Finally, don’t forget to sign the form and submit it according to the guidelines.

How to fill out the Request for Religious Exemption to Immunization?
1
Review the form requirements thoroughly.
2
Provide written explanations of your religious beliefs.
3
Indicate your stance on immunizations clearly.
4
Ensure all required signatures are obtained.
5
Submit the completed form through the specified channels.
Who needs the Request for Religious Exemption to Immunization?
1
Students at Pace University who wish to claim a religious exemption from immunizations.
2
Parents or guardians of students under 18 needing to explain their religious beliefs.
3
Individuals concerned about vaccination requirements for school attendance.
4
Students who hold sincere religious beliefs against immunizations.
5
New students registering at Pace University and requiring exemption documentation.
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What are the important dates for this form in 2024 and 2025?
Keep in mind that the submission dates for the religious exemption form will typically align with the university's enrollment timelines for each academic year. Check the Pace University academic calendar for 2024 and 2025 to confirm exact due dates.

What is the purpose of this form?
The purpose of this form is to allow students to request a religious exemption from mandatory immunizations required for attending Pace University. New York State law permits such exemptions only under sincere religious beliefs, hence the form must reflect genuine convictions. It ensures that students who hold these beliefs have an opportunity to express them formally and avoid educational disruption due to vaccination requirements.

Tell me about this form and its components and fields line-by-line.

- 1. Student Name: Full name of the student requesting the exemption.
- 2. Student ID#: University identification number of the student.
- 3. Date of Birth: Date of birth of the student.
- 4. Exemption Request Explanation: Written explanation of the request for exemption.
- 5. Religious Principles Description: Details about the religious beliefs guiding the objection to immunization.
- 6. Signature: Area for the student and, if applicable, a parent or guardian to sign.
What happens if I fail to submit this form?
Failure to submit this form may result in the inability to attend classes or participate in university activities, as immunization compliance is mandatory for enrollment. It is critical to understand the implications of not submitting the exemption request promptly.
- Ineligibility for Enrollment: Students who do not submit this form may not be allowed to enroll in classes.
- Access Restrictions: Religious exempt individuals may face restrictions during health outbreaks.
- Lack of Compliance: Failure to comply with the immunization requirements can lead to disciplinary actions.
How do I know when to use this form?

- 1. New Student Enrollment: For new students who need to submit exemption requests upon joining the university.
- 2. Annual Review: Necessary for students wishing to update or renew their exemption status.
- 3. Outbreak Situations: Used in cases where there is an outbreak or exposure on campus.
Frequently Asked Questions
How do I edit my request for an exemption?
You can easily edit your exemption request using the PrintFriendly editor, which allows you to modify text and adjust details as necessary.
Can I save my edited PDF?
While you cannot save directly on the site, you can download your edits to your device.
What if I need help filling out the form?
Refer to our guidelines on how to complete the form or contact university support for assistance.
How do I upload my completed form?
Once your form is edited and saved, follow the university's instructions on uploading it securely via their patient portal.
Does the form need to be signed?
Yes, both the student and their parent or guardian must sign the document if the student is under 18.
What information do I need to provide?
You must explain your religious beliefs, detail your views on immunizations, and confirm that you've read the necessary documents.
Is there a deadline for submission?
Make sure to check the university’s academic calendar for important deadlines relating to form submissions.
Can I edit a signed PDF?
Yes, you can make edits to your PDF, including the addition of signatures before finalizing it.
How do I share my PDF with others?
Use the PrintFriendly sharing feature to easily send the PDF to your desired recipients.
What if I encounter technical issues?
Reach out to our support team for troubleshooting assistance.
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