HomeMy WebLinkAboutOCDSB 955 Religious Accommodation Request FormAppendix B to PR.667.HR
OCDSB 955
OCDSB 955 Religious or Creed-Based Accommodation Request Form
Employee Name:School/
Dept:
Area(s) of religious accommodation (select all that apply):
School opening and closing exercises
Leave of absence religious holy days or days of significance
Prayer
Dietary requirements
Fasting
Religious dress/attire
Modesty requirements in physical education
Participation in daily activities and curriculum (i.e. music, gym, overnight trips)
Other (please specify)
Reason for accommodation:
Employee Signature:Date:
To be Completed by Office
Summary of discussion with employee:
If religious accommodation is granted, please note any agreed upon areas of modification or substitution:
If religious accommodation is not granted, please note why (including costs) and next steps:
Principal/Supervisor/
Manager Signature:Date:
Municipal Freedom of Information and Protection of Privacy Act: Personal information on this form is collected under the
legal authority of the Education Act, R.S.O. 1990, c.E-2, and regulations as amended. This information will be used for
administrative purposes for providing religious accommodation for staff. Questions regarding this collection should be
directed to the Freedom of Information Coordinator, Ottawa Carleton District School Board, 133 Greenbank Road,
Ottawa, Ontario Tel: 613-596-8211, ext. 8310.
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