Request+for+Reconsideration+Policy

IFBC-R __Instructional__ __Materials and__ __Media__ __Centers__ IFBC-R-3


 * CITIZEN’S REQUEST FOR RECONSIDERATION**
 * OF INSTRUCTIONAL MATERIALS**

AUTHOR_________________________ MEDIA______________________ TITLE_________________________________________________________ Publisher (if known)_____________________________________________ Request Initiated by______________________________________________ Telephone_____________________ Address_________________________ City__________________________ Zip Code_________________________

COMPLAINANT REPRESENTS

______ Himself/Herself (Name of organization) (Identify Other Group)

1. To what in the material do you object? Why? (Please be specific, cite pages, etc.)

2. Did you read or view the entire item? ________ What parts?

3. Have you spoken with professional educators about this material? ____ Yes ____No

4. What would you like your school to do about this? ______ Do not assign it to my child. ____ Withdraw it from all students. ______ Send it back to the building for re-evaluation. Assign to another age/grade level.

(Signature of Complainant) (Date)