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REQUEST FOR REEVALUATION OF INSTRUCTIONAL MATERIALS |
1420-E | |
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Request initiated by: ____________________________________________________________ Date: _______________________________ Telephone: ______________________________
Address: ______________________________________________________________________ Complainant represents: Self__________ Group (name): _________________________________________________________________ TITLE: _______________________________________________________________________ AUTHOR:_____________________________________________________________________ Publisher or Producer: ___________________________________________________________ Publisher's recommended grade level: ___________
Book ________ AV Material (please specify format) __________ Other __________ Have you read/heard/seen the material in its entirety? ____________ 1. To To what do you specifically object? Please cite specific passages, pages, etc.________________________________________________________________________ 2. Is y Is your objection to this material based upon your personal exposure to it, upon reports you have heard, or both?________________________________________________________________________ 3. WhWhat do you believe is the theme or purpose of the material?________________________________________________________________________ 4. WhWhat do you feel might be the result of reading/viewing this work?________________________________________________________________________ 5. In iIn it's place, what work of equal value would you recommend that would convey as valuable a picture and perspective of a society or a set of values?________________________________________________________________________ Do you wish to make an oral presentation of 15 minutes or less to the Materials Review Committee?_______ __________________________________ _________________ Signature Date |
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| Date of Approval: December 9, 2002 |