Religious, Moral, Ethical Accommodation Request

The University of Oregon is committed to providing reasonable accommodations for its employees’ sincerely held religious, moral, and ethical beliefs. Such accommodations are intended to foster inclusivity and tolerance by providing adherents with an opportunity to abide by, or practice the tenants of, sincerely held religious, moral or ethical beliefs.

Human Resources is responsible for working with employees and their supervisors/ departments to address these requests. Each request is assessed on an individual basis.

As a preliminary step in the process, we ask that you provide the information requested on this form so that we can better understand your need for accommodation.

Any information you provide Human Resources regarding your religious, moral or ethical beliefs or request for accommodation is maintained by Human Resources and is not shared with university employees who do not have a legitimate need to know the information. While the University will take your specific request for accommodation into account, it may seek to identify and provide equally effective, less burdensome alternatives, if available. It is also important to understand that in some instances the university may not be able to grant you an accommodation. Please be advised that in some circumstances the University may require additional information regarding the religious beliefs or practices that you identified.

Following receipt of this form, Human Resources will contact you to discuss next steps in the process. Completing this form does not prevent you from modifying or withdrawing your request for accommodation at any time, for any reason.

We appreciate your efforts to help us understand and accommodate your religious, moral, or ethical beliefs.

Full Name*

Preferred Name*

Pronouns*

UO ID Number*

University of Oregon Affiliation*

Select

Job Title*

Department*

Manager/Supervisor Name*

Preferred Email Address*

Alternate Email Address

Preferred Phone Number*

Phone

Preferred Mailing Address*

Religious, Moral, or Ethical Belief*

Please identify your religion or sincerely held religious, moral or ethical belief.

Accommodation Requested*

Please describe the religious accommodation you are requesting.

Support for Belief*

Please explain the religious, moral, or ethical nature of the belief or practice warranting the requested accommodation. You may instead upload supporting documentation below.

Supporting Documentation

If you have supporting documentation that describes the religious, moral, or ethical nature of the belief or practice, please upload that here.

Drag and drop files here or

Job Conflict*

Please explain how the requirements of your job conflict with your religious, moral or ethical beliefs.

Additional Information or Comments

Please provide any additional information that you believe is relevant to your request for accommodation.

Attestation of Accuracy*

I certify that I am submitting this form on behalf of myself or as a support person for another, and that to the best of my knowledge the information provided in this form is true and accurate.

Send me a copy of my responses

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