• Vaccination Exemption Application

    Vaccination Exemption Application

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  • 1.1 I, the undersigned,

  • Staff Member Type*
  • Format: (000) 000-0000.

  • Currently a UWC Student and UWC Staff Member
  • Currently also a UWC Staff Member*
  • Currently also a UWC Student*
  • seek to apply for an exemption from the University's Policy related to receiving the COVID-19 vaccine.

    1.2 The reason for this application for exemption from the University's Policy is based on the following reason:

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  • 1.3 I need to access the UWC Campus by*
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    2 digit month, 2 digit day, 4 digit year
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