1420-E
1420-E
REQUEST FOR RECONSIDERATION OF
REQUEST FOR RECONSIDERATION OF
INSTRUCTIONAL OR LIBRARY MATERIALS
INSTRUCTIONAL OR LIBRARY MATERIALS
Title_________________________________________________________________
Author________________________________ Type of Material__________________
Publisher
Request Initiated by ________________________ Telephone __________________
Address_________________________ City ________________ Zip ____________
Complainant represents: _________________________ Himself/Herself
_______________________ Name of Organization
________________________Identify other group
1. To what do you object? (Please be specific. Cite pages if a book)
2. What do you feel might be result of using this material ?
3. For what age group would you recommend this material, if at all?
4. Did you see or read all the material?
5. Are you aware of what professional critics think about this material? (If you have specific reviews, please attach them to this request.)
6. What do you believe is the theme of the material in question? Or why do you think this material exists?_________________________________________________
7. Please indicate below what you would like our school to do about this material?
________________________________________ Do not assign it to my child ________________________________________ Do not assign it to any child _____________________________________ Withdraw it from the school district
________________Send it back to a reliable educational source for re-evaluation
8. What better quality material would you recommend in its place?
Signature…………………………..
Date………………………………..
ADOPTED: July 24. 1996 WAYNE CENTRAL SCHOOL DISTRICT
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