Request for Reconsideration of Library Materials

The Ingalls Memorial Library selection criteria are described in detail in the Collection Development Policy.  This form will be reviewed by the Library Director, and you will be contacted with a response.  Please note:  your comments are public records.  However, your name, address, and phone number will be kept confidential from the general public to the extent allowed by law, including the USA Patriot Act.
Patrons who would like the Library to reconsider a title’s place in the collection are required to complete this form.

Date _____________
Name ________________________________  Telephone _______________________________
Address ____________________________ City _________________  State _________ Zip _______
I represent:
☐ Myself
☐ Organization_________________________________________________________________

Material for Consideration
Title: ____________________________________________________________________
Type of material (book, DVD, magazine, etc.) ______________________________________
Author / Producer / Publisher __________________________________________________
Call Number (Spine Label) ___________________________________
Did you read, view or listen to the material in its entirety?   Yes ☐     No ☐
Have you read any reviews of this material?    Yes ☐     No ☐
Have you read the Ingalls Memorial Library Collection Development Policy?   Yes ☐     No ☐
Please describe your concerns regarding this material (please be specific, list page numbers/sections).
Use the back of the page if necessary: __________________________________________________
_______________________________________________________________________________
________________________________________________________________________________
 
______________________________________________________________
 
 (signature)                                                                                         (date)

Printed copies of this form are available at the library.