Request for Reconsideration of Materials or Programs

This form constitutes a written request for staff to reconsider materials in the collection or programs affiliated with the library. A separate form must be completed for each work and/or program affiliated with the library. Incomplete forms will not be considered. A complaint about a program must filed no later than five working days after the scheduled date of the event. Only residents of the library's service area may submit this form.

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Patron's Information

Do you represent: *

Yourself

An orgranization

Other (specify below)

Other (please specify)

Name *

Mailing address *

Phone or email *

Signature (electronic) *

Date *

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Information About the Work or Program

Other material (please specify)

Author / Performer Name(s) *

Title *

What is your objection to the material or program? Please be specific and cite pages or scenes. *

Did you read, view, or listen to the entire work or program? If not, what parts? *

What harm do you feel might result from reading, viewing, or listening to this work or program? *

Have you read any reviews? If so, please provide a citation. *

Do you have a recommendation for other material that would provide information or perspective on this topic? *

What action do you wish the library to take? *

Request for Reconsideration of Materials or Programs

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