"I would never, ever say that my books should be in every home, every school, or every library or bookstore in America. But I would say that in our democracy, any person, any family, school, library, organization, health professional, or clergy members who chooses to have my books should have the right to do so and that right needs to be respected and protected as well.'
Robie Harris, author of It's Perfectly Normal: A Book about Changing Bodies, Growing Up, Sex, and Sexual Health
The school board of Mainstream County, U.S.A., has delegated the responsibility for selection and evaluation of library/educational resources to the school library professional staff/curriculum committee, and has established reconsideration procedures to address concerns about those resources. Completion of this form is the first step in those procedures. If you wish to request reconsideration of school or library resources, please return the completed form to the coordinator of library media resources (or principal).
Mainstream School District
1 Mainstream Plaza
Anytown, State Zip
Date ___________________________________________________________
Name __________________________________________________________
Address ________________________________________________________
City ____________________________ State/Zip _______________________
Phone __________________________ Email __________________________
Do you represent self? ____ Or an organization? ____ Name of Organization ___________________________
1. Resource on which you are commenting:
___ Book (e-book) ___ Movie ___ Magazine ___ Database
___ Audio Recording ___ Digital Resource ___ Textbook ___ App
___ Newspaper ___ Game ___ Streaming Media ___ Other
Title ________________________________________________________________________
Author/Producer _______________________________________________________________
Is the resource part of the curriculum, library collection, or other?
___________________________________________________________
2. What brought this resource to your attention?
___________________________________________________________
3. Have you examined the entire resource? If not, what sections did you review?
___________________________________________________________
4. What concerns you about the resource?
___________________________________________________________
5. Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?
___________________________________________________________
6. What action are you requesting the committee consider?
___________________________________________________________
The trustees of Mainstream Public Library have established a materials selection policy and a procedure for gathering input about particular items. Completion of this form is the first step in that procedure. If you wish to request reconsideration of a resource, please return the completed form to the library director.
Mainstream Library
1 Mainstream Plaza
Anytown, State Zip
Date ___________________________________________________________
Name __________________________________________________________
Address ________________________________________________________
City ____________________________ State/Zip _______________________
Phone __________________________ Email __________________________
Do you represent self? ____ Or an organization? ____ Name of Organization ___________________________
1. Resource on which you are commenting:
___ Book (e-book) ___ Movie ___ Magazine ___ Audio Recording
___ Digital Resource ___ Game ___ Newspaper ___ Other
Title ________________________________________________________________________
Author/Producer _______________________________________________________________
2. What brought this resource to your attention?
___________________________________________________________
3. Have you examined the entire resource? If not, what sections did you review?
___________________________________________________________
4. What concerns you about the resource?
___________________________________________________________
5. Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?
___________________________________________________________
6. What action are you requesting the committee consider?
___________________________________________________________
The faculty at Mainstream Academic Library, U.S.A., have established a materials selection policy and a procedure for gathering input about particular items. Completion of this form is the first step in that procedure. If you wish to request reconsideration of a resource, please return the completed form to the dean of libraries.
Mainstream Academic Library
1 Mainstream Plaza
Anytown, State Zip
Date ___________________________________________________________
Name __________________________________________________________
Address ________________________________________________________
City ____________________________ State/Zip _______________________
Phone __________________________ Email __________________________
Do you represent self? ____ Or an organization? ____ Name of Organization ___________________________
1. Resource on which you are commenting:
___ Book (e-book) ___ Movie ___ Magazine ___ Audio Recording
___ Digital Resource ___ Textbook ___ Newspaper ___ Other
Title ________________________________________________________________________
Author/Producer _______________________________________________________________
2. What brought this resource to your attention?
___________________________________________________________
3. Have you examined the entire resource? If not, what sections did you review?
___________________________________________________________
4. What concerns you about the resource?
___________________________________________________________
5. Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?
___________________________________________________________
6. What action are you requesting the committee consider?
___________________________________________________________
Request for Reconsideration of Library Resources
Name ______________________________________
Date ________________
Address _________________________________________________________
Phone ___________________________
Email: __________________________
Do you represent self? ____ Organization? ____
Resource on which you are commenting: ____ Book ____ Textbook ____ Video ____ Display ____ Magazine ____ Library Program ____ Audio Recording ____ Newspaper ____ Electronic information/network (please specify) ____ Other ___________________________
Title ____________________________________________________________
Author/Producer ___________________________________________________
What brought this resource to your attention? Have you examined the entire resource? What concerns you about the resource? (use other side or additional pages if necessary) Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?
Many of these resources and programs are funded under the provisions of the Library Services and Technology Act from the Institute of Museum and Library Services.