New City Library Collection Policy, Appendix F

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APPENDIX F

NEW CITY LIBRARY

CITIZEN’S REQUEST FOR RECONSIDERATION OF MATERIAL

IMPORTANT: The entire form must be completed in order for an item to be reconsidered.

PLEASE PRINT

Date __________________

Request initiated by: ____________________________________________________

Address _______________________________________ Telephone ______________

Complainant represents:
___him/herself
___organization ________________________________________________________

FORMAT: ____Book ____Video ____Audio cassette ____Compact disc
____Book-on-Tape ____other (specify) ___________________

Author/Artist/Director: ____________________________________________

Title: __________________________________________________________

Publisher/Producer: _______________________________________________

1. Did you read/view/listen to the entire item? __________________________
Parts _________________________________________________________

2. To what do you object: (Cite pages, scenes, etc.) ______________________
______________________________________________________________
______________________________________________________________
3. To what do you approve: (Cite pages, scenes, etc.) _____________________
______________________________________________________________
______________________________________________________________
4. What do you believe is the theme of this book/video/audio recording? ______
______________________________________________________________
______________________________________________________________
5. What do you feel might be the result of reading/viewing/hearing this material?
______________________________________________________________
______________________________________________________________

6. Are you aware of the judgment of this material by critics? __________________

7. What would you like the library to do about this item? _____________________
_________________________________________________________________
_________________________________________________________________

8. What alternative book/video/audio recording of equal quality do you recommend
that will convey a similar perspective? __________________________________
_________________________________________________________________

Signature ___________________________

12/20/90

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