CNM Religious & Cultural Accommodation Request

CNM Religious & Cultural Accommodation Request

This form is to request accommodations or exemptions from course requirements or policies due to sincerely held religious/cultural beliefs. Please submit as soon as you are aware of the conflict and at least 7 days prior to the event.

If you need assistance completing this form due to disability, please contact the ADA Coordinator at 505-224-4758 or email ADACoordinator@cnm.edu.

CNM may not be able to approve all requests if they create an undue burden or considerable alteration of course requirements.

Accommodations do not relieve students of the responsibility for completion of any part of the coursework missed as the result of a religious observance.

Contact Information

Name*

Preferred Name

Preferred Pronouns

CNM ID Number*

Phone Number*

Phone

Email Address*

Have you submitted this request to your instructor(s)*

Yes

If yes, did the instructor deny your request?*

Yes

Observance Information

Belief Affiliation*

Please check this box if this request is urgent (less than 3 days away).

For example, a funeral or other ritual that may occur with very little notice.

Date(s) Requested for exemption*

Please enter the date or date range for the observance.

Name of the Event/Observance you plan to attend.*

Is travel outside the Albuquerque Area required for the observance?*

Yes

Please indicate time required for travel if it is in addition to the observance time frame*

For example, the observance is 3 days, but a day of travel is required to get there and a day to get back.

Please describe how the course interferes with your belief observance or practice.*

Examples include: Feast days and exams falling on the same date, funeral obligations and assignment deadlines, significant religious holidays not accounted for in the academic calendar, etc.

Course Information

Affected Course(s)*

Please list which course(s) are impacted by the observance.

Instructor Information*

Please list the name and email address of the instructor(s) in the following format, Sol T Suncat, sol@cnm.edu

Religious Accommodation Request

What reasonable accommodation are you requesting?*

Examples:

rescheduling a test scheduled for the date of an important observance or essential practice
extensions on assignments due during a period of observance

Attestation

By submitting this form, you are attesting to your sincerely held religious belief as defined by Title VI of the Civil Rights Law of 1964.

Send me a copy of my responses

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