Patron Reconsideration Form Library Materials

Patron Reconsideration Form Library Materials

Please fill out this form highlighting a specific resource that is of concern and the reasons for reconsidering its inclusion in the library's collection. Once the form is filled out, please hit “submit”. All comments submitted will come to the attention of the Director of County Library Services who will send the patron a written reply.
Patron Name*

First NameLast Name
Date Submitted*

MonthDayYear
Date

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Evening Phone*
Day Phone*
Who do you represent?*

SelfOrganization
Name of Organization*
Type of material on which you are commenting:*

Physical or Digtal BookPhysical or Digital Audio BookDVD/MediaMagazine/Newspaper or JournalOther
Title*
Author*
Publisher/Producer (if known)
Publication/Production Date (if known)

MonthDayYear
Publication Production Date if known

MonthDayYear
Date
What brought this material to your attention?*
Have you read, listened to, or watched the entire content of the material. If not, what sections did you review?*
What concerns you about the material? Please be specific and give page numbers if applicable.*
What do you think would be the result or impact of providing this material to the public and why?*
Are you aware of MCFL's Collection Development Policy, AB 1825, the California Freedom To Read Act and/or the ALA's Library Bill of Rights and Freedom to Read Act?*

YesNo
Do you have suggestions for materials, or resources that the library could provide as additional or alternative information on this topic?*
Marin County Civic Center * 3501 Civic Center Drive, # 414 San Rafael, CA 94903 * 415.473.3220 http://marinlibrary.org
Should be Empty: