Request for Reconsideration Form
Reconsideration Form for patron use.
Request for Reconsideration of Library Material
Barton County Library
If you wish to request reconsideration of library materials, please complete this form and return it to Director; Barton County Library; 300 W. 10th St.; Lamar, MO 64759. Please Note: your request will be forwarded to the Library Board of Trustees and it will become a matter of public record.
Confirm: Are you a resident of Barton County Missouri? _____ yes _____ no
Confirm: Do you have a library card in good standing? _____ yes _____ no
Name___________________________________________________________________________________
Address________________________________________________________________________________
Phone__________________________________________________________________________________
Email __________________________________________________________________________________
Is this request made on behalf of:
Yourself _________________________
An Organization________________ Name of Organization___________________________________________________
1. Resource on which you are commenting:
TITLE:_____________________________________________________________________________________________________________
AUTHOR/PRODUCER:___________________________________________________________________________________________
COPYRIGHT DATE: _____________________________
Book ______ Video ______ Audio Book _____ Magazine ______ Newspaper ______
Library Program______ Library Display ______ Other ______
2. What brought this resource to your attention?
3. Did you read, view or listen to the entire work? Yes ________ No________
4. Please describe what you find objectionable: (Please be specific, citing page numbers, etc; use other side if needed.
5. What do you feel might be the result of reading/listening to/viewing this material?
6. Would you recommend this material for a different age group or location? If so, please specify.
7. Can you suggest other material to take its place?
8. Is there anything good about this work?
9. Are you aware of the judgment of this work by critics?
10. What other comments would you like to make?
Signature_____________________________________________________ Date______________________
Staff Initials ____________ Date Received ____________
Director Initials ____________ Date Received ____________ Date of Response ____________