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Exhibit 1, Citizen's Request for Reconsideration of an Item

 

Citizen’s Request for Reconsideration on an Item

 

Item:_____________________________________________________________________


Request initiated by:_______________________________________________________

 

Telephone: __________________Address: ________________________City:_________

 

Complainant Represents: ______________________________________________(Self)

 

(Name of Organization)____________________________________________________

 

(Identify other Group)_____________________________________________________

 

To what do you object?____________________________________________________

__________________________________________________________________________

What do you feel might be the result of using the item?__________________________

____________________________________________________________________________

 

For what age would you recommend this item?_________________________________

 

Did you review the entire item?______________________________________________

 

Are you aware of the judgment of this item by literary critics?_____________________

 

What do you believe is the theme of this item?__________________________________

 

What would you like your Library to do about this item?_________________________


What item of equal quality would you recommend be substituted in its place?________


Signature of complainant: ___________________________________Date: __________

Exhibit 1