Tiverton Library Services

 

A REQUEST FOR RECONSIDERATION OF LIBRARY RESOURCES OBJECTION TO INCLUSION

 

1.      Type of resource (book, magazine, newspaper, textbook, video, film, filmstrip, art work, sound recording, tape, electronic information, library program, display, etc.)__________

 

  1. Author/Editor_______________________________________

Title_______________________________________________

Publisher/Producer___________________________________

Date of publication___________________________________

 

  1. Work included in adult_______ children’s_____ or young adult collection_______

 

  1. Request initiated by:

Name__________________________________

Address_____________________________________

City______________________State__________ZIP______________

Telephone No.__________________________________

 

Do you represent an organization or group?_______________

If yes, please identify__________________________________

 

  1. What is your objection to this work?  Please be specific; cite pages, sections, etc.