Please note: This form can be picked up at the library. Ask at the front desk.
Title: ________________________________________________________________
Author: ______________________________________________________________
Publisher: __________________________ Publication Date ___________________
Name: _______________________________________________________________
Organization: _________________________________________________________
Address: _____________________________________________________________
Phone: _____________________________
What is your objection to this material? Please be specific; cite pages or scenes
Did you read the entire book or view the entire video?
Yes: ____ No: ____ If not, what parts? __________________________________
Are there titles that you would recommend in place of this work?
According to the collection development policy, the library has a process to follow when library material has been challenged:
The Library Director will report this information to the Library Board. The Library Board will then determine if the material in question was selected according to this Policy. The person raising the concern will be notified by the Library Director of the Board’s decision. Challenged materials will remain in the collection until the Board’s final decision. Under no circumstances will the personal view or taste of either the Library Director or the members of the Library Board concerning the material be criteria in making a ruling. The determination will be made solely based on compliance with the Collection Development Policy.
Signed ____________________________________________ Date ________________________