Request for reconsideration of library materials

The Library Board of Trustees of the Dodge Center Public Library has delegated the responsibility for selection and evaluation of library resources to the library director, and has established reconsideration procedures to address concerns about those resources. Completion of this form is the first step in those procedures. If you wish to request reconsideration of library resources, please fill out the form below, or pick up a paper copy of the form at the library.

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Your Name:*

Email address:*

Title of item challenged:*

Author of item:*

Your library card number:*

Publisher and year of publication:*

Address:

Are you requesting for:*

Yourself?
An organization?

Which organization?

What in the item do you object to? Please be specific (list pages or sections).*

What do you feel might be the result of reading, viewing, or listening to this item?*

What do you believe is the theme or purpose of this item?*

What positive value is there in this item?*

Did you read, view, or listen to the entire production?*

Yes
No

What do you feel the library should do with this item?*

Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?*

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