Request for Religious Holiday Observation
AY 2019-20

College / Class: Select all that apply.
Student Information

* Time off request for religious holiday observation will be considered only for the official day(s) of religious observance, as defined by the calendar year and continent. Additional or flexible time off will not be granted. Sundown will be specified as 4 p.m., Eastern Standard Time.
* Late requests will be considered only in exceptional circumstances.
* Confirmation of requested time off will be sent to the student with a copy to affected course directors and course coordinators.
* Students are responsible for making up any and all missed time and assignments at the discretion of the course directors; mandatory assignments/work must be made-up. Students are responsible for checking with course directors regarding specific mandatory content. Students will be notified, by email, of their make-up requirements by the course director or curriculum coordinator.
* The decision to excuse a student from a curricular responsibility is at the discretion of the course director dependent on the ability of the course to make-up missed required curricular activities. If the requested time off creates an undue hardship for the delivery and/or make-up of missed curricular elements, the student may not be excused by the course director(s).
* As permitted by the course director and availability of personnel for examination administration, missed exams may be scheduled prior to the time off period or immediately thereafter. Students will be notified, by email, of their alternate test date, time and location.
* Missed work/assignments may result in a grade of “incomplete” for the course.

Note: If the absence is for one day, put the same date for First day away and Last day away.

If you plan to be gone the whole day, leave the Time leaving / Time returning blank.

Request #1
Format: mm/dd/yyyy
Format: mm/dd/yyyy
Request #2
Format: mm/dd/yyyy
Format: mm/dd/yyyy
Request #3
Format: mm/dd/yyyy
Format: mm/dd/yyyy
Request #4
Format: mm/dd/yyyy
Format: mm/dd/yyyy
Do you have additional religious holidays to report?

Contact Robert Larson (330.325.6844 or if you need to document even more holidays.

Submission of this form indicates that you have read and understand the guidelines associated with requesting time off for religious holiday observation. Failure to comply with student responsibilities (noted above) will be considered a conduct concern.

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