BELGRADE COMMUNITY LIBRARY

REQUEST FOR RECONSIDERATION

 

Please describe the item in question as fully as possible. You may attach extra pages if necessary.

Title: _________________________________________________________________________

 

Author (if appropriate): ___________________________________________________________

 

Format (check one):     Book     Book on CD     DVD     Other

 

Publisher & Copyright Date: ______________________________________________________

 

Please answer the following questions:

 

What is the subject of the item? ____________________________________________________

 

Have you read, listened to, or viewed the item in its entirety? Yes      No

 

Do you have any additional information including reviews, articles, etc.? (please cite source, date and page).  Please attach any applicable information.

______________________________________________________________________________


Please state the action you wish taken on this item:
Add to the Library   Shelve elsewhere     Remove from the Library     Other (specify):

 

What are your reasons for this request? ______________________________________________

 

______________________________________________________________________________

 

Please explain how such an action would improve the Library’s service to the community:

 

______________________________________________________________________________

 

______________________________________________________________________________

 

What are the positive points of this material?


______________________________________________________________________________

 

Do you feel the material is objectionable to all patrons, or some patrons? ___________________


If you wish for the material to be withdrawn from the Library entirely,

what material of equal literary merit would you recommend in its place?

 

________________________________________________________________________

Name: ________________________________________________________________________

 

Address: ______________________________________________________________________

 

Home Telephone: _______________________     Work Telephone: _______________________

 

________________________________________________________________________

Signature                                                                                 Date

 

 

(Optional) I am acting as a spokesperson for the following group or association:

 

________________________________________________________________________

 

Contact Person: __________________________________________________________

 

Telephone Number: _______________________________________________________