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Forms hr

Religious Accommodation Request

Title VII religious accommodation request โ€” Groff standard, sincerely held belief.

Built for: All

What's inside this template

Employee

  • Employee name (required)
  • Job title (required)

Request

  • Describe the religious practice / observance requiring accommodation (required)
    Title VII protects sincerely held beliefs; you do not need to disclose religion identity
  • What accommodation are you requesting? (required)
  • How long do you need this accommodation?
    One-time / Ongoing / Recurring (e.g., weekly Sabbath)

Sign-Off

  • Employee signature (required)
  • Date submitted (required)

Common use cases

Religious holiday observance
Religious dress / grooming
Religious diet

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