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109. ATTACHMENT
Citizen's Request For Reconsideration Of A Work
Author
Paperback
Hardcover
Title
Publisher (if known)
Request initiated by
Telephone
Address
City
Zip Code
Complainant represents
Him/Herself
(Name organization)
(Identify other group)
1.
Have you been able to discuss this work with the teacher or librarian who ordered it
or who used it?
_______ Yes
_______ No
2.
What do you understand to be the general purpose for using this work?
a.
Provide support for a unit in the curriculum?
______ Yes
_______ No
b.
Provide a learning experience for the reader in one (1) kind of literature?
_______ Yes _______ No
c.
Other
3.
Did the general purpose for the use of the work, as described by the teacher or
librarian, seem a suitable one to you?
_______ Yes _______ No
If not, please explain.
4.
What do you think is the general purpose of the author in this book?
5.
In what ways do you think a work of this nature is not suitable for the use the teacher
or librarian wishes to carry out?
6.
Have you been able to learn what is the students' response to this work?
_______ Yes _______ No
7.
What response did the students make?
8.
Have you been able to learn from your school library what book reviewers or other
students of literature have written about this work?
_______ Yes _______ No
9.
Would you like the teacher or librarian to give you a written summary of what book
reviewers and other students have written about this book or film?
_______ Yes _______ No
10. Do you have negative reviews of the book?
_______ Yes _______ No
11. Where were they published?
12. Would you be willing to provide summaries of the reviews you have collected?
_______ Yes _______ No
13. 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 – Please explain.
14. In its place, what work would you recommend that would convey as valuable a
picture and perspective of the subject treated?
Signature
Date