Request for Reconsideration of School Library Book
Tipton Community School Corporation
Book Title
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Hard Cover
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Please Select
Yes
No
Paperback
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Please Select
Yes
No
Name of Author
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Name of Publisher
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Copyright Year
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Review of Book Requested By:
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Book Details
Have you read the entire book?
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Please Select
Yes
No
If yes, give a summary of the book or explain what you believe the book is about.
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Complainant Represents Themselves:
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Please Select
Yes
No
Someone Other Than Themselves:
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Please Select
Yes
No
If yes, give the name, group name or organization you are presenting.
To what in the book do you object? Please be specific and cite pages.
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What do you feel might be the result of a student reading this book? Please be specific and cite pages.
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What do you find positive or redeeming about this book? Please be specific and cite pages.
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Is there any age or group that should be allowed access to this book?
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Please Select
Yes
No
If yes, what age or group? Please be specific and explain your reasoning.
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Is there any age or group that should not be allowed to access this book?
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Please Select
Yes
No
If yes, what age or what group? Please be specific and explain your reasoning.
Have you read reviews of this book?
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Please Select
Yes
No
If yes, please list the source and the date of the review.
Are you aware of any judgement of this book and/or this author by literacy critics?
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Please Select
Yes
No
If yes, relate what you know about these literary opinions
What would you like TCSC to do about this book?
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Can you recommend another title for the school library which would present the opposite or alternative point of view in question?
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Please Select
Yes
No
If yes, please give title and author.
Please add if there is relevant documents
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