Form Details


Form Format
FormatForm Link AddressFunctionalitySize
Adobe PDF   Statement of Conscience or Religious BeliefThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill & Print200.0 kb

Form Classification
Classification / Identification:
 Form Number:010-3042EEdition date: 2016/05 
 Title:Statement of Conscience or Religious Belief
 Ministry:Education  
 Branch/ABC:Early Years & Child Care Policy Branch  
 Program:Early Years Policy Unit  
 Purpose of Form:To allow individuals to apply for religious/conscience exemptions for immunizations  

You must download Adobe Acrobat Reader (version 10.0 or above) to view/print PDF forms.
Click here for further instructions.

If PDF forms do not open in the latest versions of Firefox and Chrome, click here for the solution.


Protecting Your Information: If you are using this online service on a shared computer in a public area (i.e. public library), it is important to ensure that you do not leave the computer unattended while accessing the service. Before leaving the computer, it is also important that you fully exit the application, clear your browser's cache (This link opens in a new window) and close down your browser. This will ensure that no one else can access any personal information you may have entered.