Potsdam Public Library Policy
Category: External/Patron Concerns
Policy Subject: Challenged Material Form
Effective Date: May 9, 2000
|
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.
Patron's Request for Review of Library Materials
1. Name of Complainant:________________________________________
2. Address___________________________________________________
| 3. City___________________________ |
State_________ |
| Zip______________ |
Phone__________________ |
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
| Signature:_________________________________________ |
Date:__________________ |
| |
| Reviewed by the Director: ______________________________ |
Date: _________________ |
Recommendation of the Director:
Copy Sent to Complainant:______________________(Date)
Copy Sent to Board:__________________________(Date)
Appealed:_______________________________
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