Reconsideration Request Form

Fill out this form if you wish the Library to remove an item or move an item from one collection to another. Please come to the Library and sign the complaint. The Library Board will not act upon a Reconsideration Request until it has been signed.

Author:

Title

Publisher:

Request Initiated By:

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
E-mail

Complainant Represents:

Himself
Organization
Group

To what in the book do you object? (Be specific and cite pages, passages, or words)

What do you feel might be the result of reading this book?

For what age group would you recommend this book?

Is there anything good about this book?

Did you read the entire book? What parts?

Are you aware of the judgement of this book by literary critics?

What do you believe is the theme of this book?

What would you like your library to do about this book?

In its place, what book of equal literary quality would you recommend that would convey as valuable a picture and perspective of our civilization?

In the event that the Director and the patron disagree on the disposition of the material, do you wish for it to be brought before the Library Board for further consideration?

Please, fill out this form as completely as possible and add any additional comments regarding this book in the space below.