REQUEST FOR RECONSIDERATION OF LIBRARY MATERIALS
If you feel that a book or other item in our library does not belong, we invite you to fill out this form, print it, and leave it at the main desk. The form will be given to the library director, who will be in touch with you regarding your complaint.
Name
Date
Address
Phone number
Do you represent yourself only? Yes No
Do you represent an organization or group?
Yes
No
(please name)
Item on which you are commenting:
Book Video/DVD Audio recording
Newspaper Magazine Display
Library Program Electronic resource
Other
Title of the item
Author
Publisher
1. What elements of the work are objectionable? Please be specific.
2. What do you feel might be the result of reading/viewing this work?
3. What do you believe is the theme or purpose of this material?
4. Do you feel that this work could be acceptable for any segment of the public?
5. Have you checked to see how this work was received by reviewers?
Yes
No
6. Can you suggest other material on the same topic that would make a better addition to the library's collection?
7. Is there anything good about this material?
Last updated 06/04
