REQUEST FOR RECONSIDERATION OF LIBRARY MATERIAL

 

Type of Material _______________________________________________________________

Title _________________________________________________________________________

Author/Editor __________________________________________________________________

Publisher (if known) ____________________________________________________________

Request initiated by _____________________________________________________________

Library Card # _________________________________________________________________

Address ______________________________________________________________________

City _______________________________† State ____________ Zip† _____________________

Telephone _______________________________________

Complainant represents:

____________ Self

____________ (Name of Organization) _____________________________________________

____________ (other) ___________________________________________________________

 

1.      To what in the material do you object? (Please be specific; cite pages.)

 

 

2.      Did you read, listen to, or view the entire material? __________ If no, what parts?

 

 

3.      In your opinion, is there anything good about the material? ________________________

 

 

4.      What action do you suggest the library take regarding this material? _________________

 

 

5.      Can you suggest another item to take this oneís place? ____________________________

 

 

 

Complainantís signature __________________________________† Date __________________