Your name: ________________________________________________________________________
Telephone: ___________________ E-mail: _______________________________________
- Did you read, listen to, or view the entire material? (circle one) Yes No
- If “no”, which parts did you read, listen to, or view?
- What passages did you find objectionable?
- To whom do you feel this material would be unacceptable?
- If this material were to remain in the library, what would the effect be?
Approval Date: May 2013
Amended: February 2016, February 2017
Revision/Review Date: February 2020
Approval Signature: original signed by Board Chair: Elizabeth Luck