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The following form will be used for Potsdam Public Library patrons who wish to request that material be removed from the collection. Note: see "Reconsideration of Library Materials" in Potsdam Public Library Policy/collection Development & Maintenance.  1. Name of Complainant:________________________________________ 2. Address ___________________________________________________
4. Type of material objected to: book magazine illustrations cassettes compact disc video other (describe) 5. Author: 6. Title: 7. Publisher: 8. Have you reviewed the entire work? If no, what sections? 9. Are you aware of the judgment of this work by recognized literary critics? 10. What do you believe is the theme of this work? 11. What is your specific objection to this material? 12. Is there anything good about this material? 13. What do you feel might be the result of reading/hearing/viewing it? 14. What action would you recommend be taken regarding the use of this material? 15. For what age group would you recommend this material? 16. Other comments
Recommendation
of the Director: Copy Sent
to Board: ______________________(Date)
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