REQUEST FOR RECONSIDERATION OF BOOKS, by lizbethbennett

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									REQUEST FOR RECONSIDERATION OF BOOKS, LEARNING ACTIVITIES, OR TEACHING PRESENTATIONS This form is intended for use by parents or patrons of Norris School District #160 who have a concern or cut a library book, course textbook, specific learning activity, or instructional presentation by a teacher or resource person on the basis he/she considers the material, activity, or presentation objectionable or inappropriate for the students involved. The form is to be completed and returned to the building principal who will forward the form to a Review Committee, appointed by the Superintendent of Schools, for the committee's consideration. The person(s) signing the form will be invited to appear before the committee when they review the concern or complaint. The committee will make a recommendation to the Superintendent regarding the continued use of the material, activity, or presentation. Request initiated by:_____________________________________________Date:_________________________ Address (Street / Box,Town, Zip)_______________________________________________________________ Telephone____________________________________________ Describe the material, activity, or presentation which you have a concern or complaint: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Where is the material located or the activity / presentation used (e.g., building, library, course, classroom, teacher, etc.)? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ What in the material, activity, presentation do you object? Please be specific and cite pages, etc. ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________

What do you feel might be the result of using this material, activity, or presentation? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ For what age group, if any, would you recommend this material, activity, or presntation? ______________________________________________________________________________________________ ______________________________________________________________________________________________ Is there any value in the use of the material, activity, or presentation? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Did you review the material, observe the activity, or hear the presentation? ______________________________________________________________________________________________ ______________________________________________________________________________________________ Are you aware of any judgement of this material, activity, or presentation by educational authorities or literary critics? ______________________________________________________________________________________________ ______________________________________________________________________________________________ What do you believe is the purpose or theme for using the material, activity, or presentation? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________

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What would you like the school to do about this material, activity, or presentation? __________ __________ __________ Do not assign it to my child. Withdraw it from school and all children. Other (specify):______________________________________________________________

Are there other materials, activities, or presentations to which you would not be concerned or object to that would be of equal value and accomplish the same purpose or theme? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________

Signature of Parent / Patron____________________________________________________________________ Date______________________________________

Parent / Patron represents: __________ __________ __________ Himself / Herself Organization (identify)________________________________________________________ Other Group (identify)________________________________________________________


								
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