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Chapter 5: Protecting the Public's Freedom to Read

Section: Sample - Request for Reconsideration of Library Resources

The __________ Library has delegated responsibility for selection and evaluation of library resources to___________ (director, selection committee, etc.) and has established reconsideration procedures to address concerns about those resources. Completion of this form is the first step in those procedures. If you wish to request reconsideration of library resources, please return the completed form to __________.

Name     Date  
Address     City  
State     Zip  
Phone        

Do you represent:   [  ] self?        [  ] organization?

Resource on which you are commenting: 
[  ] book  [  ] textbook  [  ]  video display  [  ] magazine  [  ] audio
[  ] recording  [  ] newspaper  [  ] library program
[  ] electronic information/network (please specify) _________________________________________________________________

Other ____________________________________________________________

Title _____________________________________________________________

Author/Producer ___________________________________________________

What brought this resource to your attention?

 

Have you examined the entire resource?                                              

 

What concerns you about the resource? (Use back or additional paper if needed.)

 

What resources do you suggest to provide additional or other viewpoints on this topic?

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