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The following is a edited and revised version of a letter which resulted in receiving a green card without vaccination. Brackets [ ] indicate areas where you will fill in the item as applies to yourself. Or in the case of the statement about 'religious conversion', 'out of state religious advisor', etc - eliminate if it does not apply.
October 2003
INS

To Whom It May Concern:

This is a personal statement to explain my position regarding immunizations. As a student of natural health I understand the position of the United States Government to protect its citizens from potential dangers from infectious disease. I have submitted to a comprehensive medical exam and have been found to be healthy. Never has my lack of vaccinations been an issue regarding the safety of my fellow employees or the public at large. I have submitted documentation from [country of origin] indicating that I have had naturally most of the childhood illnesses that are required for vaccination. Because I have had these illnesses, I have natural immunity and do not require additional inoculations.

I have lived in the United States as a student on and off for [9] years. This is a wonderful country, and I consider it a privilege to be able to live and work here with my [wife]. One of the things I admire the most about the polices of The United States is the respect of personal liberties. I decline to receive vaccinations based on my religious beliefs. According to my religious convictions I not only decline foreign inoculations into my body, but all medications. [When I was 13 years old my family and I had a religious conversion.] Since that time till today I have relied on God as my Lord and protector.

According to the INS web site from the Headquarters and Adjudication Division, all persons who object to receiving vaccinations based on moral and religious convictions need to submit an I-601 waiver form and pay the $195 filing fee. They indicate that the application must meet three requirements:
(1) You oppose vaccination in any form;
(2) The opposition is based on religious beliefs or moral convictions (whether or not as a member of a recognized religion);
(3) the religious or moral conviction is sincere.

I have submitted this form, complied with the requirement, and paid the $195 fee. In addition to this letter, you will find an attached letter from my local minister in whose church I am an active member[, and a letter from my out of state spiritual adviser in my file.] These letters confirm that receiving vaccination is against my religious beliefs.
     Thank you for your time and consideration.

      [Signature]



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