Adopted:          01/18/1992

Revised:                                                                                                           361 Exhibit

School District of Prairie Farm

Request for Reconsideration of Library Materials

Title:  ______________________________________     Book                              Periodical               Other

Author:  ______________________________________________________________________________________

Publisher:  ____________________________________________________________________________________

Request initiated by:  ____________________________________________________________________________

Address:  ____________________________________________  Phone:  _________________________________

City:  _____________________________________________  State:  _______________  Zip:  ________________

1.  To what in the work do you object? (Please be specific and site pages.):  ________________________________

_____________________________________________________________________________________________

2.  Did you read the entire work?  __________  What parts?  ____________________________________________

3.  What do you feel might be the result of reading this work?  ___________________________________________

_____________________________________________________________________________________________

4.  If you object to this work, for which age group would you recommend this?  _____________________________

_____________________________________________________________________________________________

5.  What do you believe is the theme of this work?  ____________________________________________________

_____________________________________________________________________________________________

6.  Are you aware of judgments of this work by literary critics?  __________________________________________

_____________________________________________________________________________________________

7.  What would you like your library/school to do about this work?

                                Do not assign / lend it to my child

                                Return it to the staff selection committee/department for re-evaluation

                                Other, explain:  __________________________________________________________________

8.  In its place, what work would you recommend that would convey as valuable a picture and perspective of the subject treated?  ________________________________________________________________________________

CROSS REFERENCE:. 361 Request for Reconsideration of Library Materials