Student Request for Religious Accommodation
ALL students are permitted to use the prayer/reflection rooms (F6 and two rooms in the library) at Holmes during non-instructional times:
  • 7:10-7:25 AM
  • Scheduled Lunch Period
  • 2:05-2:15 PM
Students who wish to use the prayer/reflection rooms during instructional times must have a written request for the accommodation from their parents/guardians.  This form only needs to be completed if you are giving permission for your student to miss instructional time at a certain time to use the prayer/reflection room. 

NOTE: On rare occasions when supervision is not available for F6 or the library, students will be required to use an alternate supervised location.

Students are expected to use the prayer/reflection room for its intended purpose only and should be mindful about arriving to class on time or getting back to class in a timely manner.  Parents/guardians of students who do not follow this expectation will be contacted and progressive discipline in accordance with the FCPS Student Rights & Responsibilities will be followed.  
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Student Last Name *
Student First Name *
Grade Level *
Name of Parent/Guardian completing this form *
Email address and/ or phone number of Parent/Guardian completing this form *
What specific time(s) of the school day are you requesting for your student to miss class to use the prayer/reflection room? *
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