Request for Reconsideration of Material Form
The school board of Upper Sandusky Exempted Village Schools, has delegated the responsibility for selection and evaluation of library/educational resources to the school library professional staff/curriculum committee, 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 school or library resources, please return the completed form to the coordinator of library media resources (or principal).
Upper Sandusky High School
800 N. Sandusky Ave.
Upper Sandusky, OH 43351
Date ___________________________________________________________
Name __________________________________________________________
Address ________________________________________________________
City ____________________________ State/Zip _______________________
Phone __________________________ Email __________________________
Do you represent self? ____ Or an organization? ____ Name of Organization ___________________________
1. Resource on which you are commenting:
___ Book (e-book) ___ Movie ___ Magazine ___ Database
___ Audio Recording ___ Digital Resource ___ Textbook ___ Newspaper
___ Game ___ Streaming Media ___ Other
Title ________________________________________________________________________
Author/Producer _______________________________________________________________
Is the resource part of the curriculum, library collection, or other?
___________________________________________________________
2. What brought this resource to your attention?
___________________________________________________________
3. Have you examined the entire resource? If not, what sections did you review?
___________________________________________________________
4. What concerns you about the resource?
___________________________________________________________
5. Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?
___________________________________________________________
6. What action are you requesting the committee consider?
___________________________________________________________