Student Affairs COVID-19 Resources

PURPOSE AND INSTRUCTIONS: 

Per university policy, all individuals, regardless of vaccination status, must wear a mask at all times while inside “University Premises,” unless eligible for a medical or religious exemption. This form is to be completed if a current Wichita State University student is requesting an exemption from the Wichita State University (WSU) mask requirement for religious reasons. While waiting for an exemption decision, student must continue to follow all WSU policies and guidance on masks and follow all other University safety measures in place. 

SECTION I: STUDENT INFORMATION 

In the space below, please provide a written statement explaining the nature and tenets of Student’s sincerely held religious belief, practice, or observance and a statement of why the sincerely held religious belief, practice, or observance should exempt Student from wearing a mask while on-campus: 

Please provide any additional information that you think may be helpful in reviewing your request. If desired, provide supporting documentation. 

SECTION II: STUDENT CERTIFICATION 

By completing this form and signing below, I, a currently enrolled Wichita State University Student, am requesting a religious exemption and believe I meet the qualifications for such an exemption. I confirm that the information provided on this form is accurate and truthful to the best of my knowledge. I further understand and agree that: 

1. I may be required by WSU to comply with additional restrictions and preventive guidance (e.g., regular testing, wearing personal protective equipment, social distancing, removal from facility in the event of an outbreak, etc.). 

2. Any exemption granted may be temporary and I may be required to provide additional documentation and/or certifications in the event of a request by the university or any change in my circumstances, University policy, or the law, including federal guidance related to religious exemption requests.