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Library Collection Form
Library Collection Materials Reconsideration Request
This form requires Javascript to be enabled for submission and authorization.
*
Required
Name
*
required
First Name
Last Name
Email Address
*
required
Which of the following best represents you?
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required
Current Parent
Current Student
Current Employee
Arlington Citizen
An Organization
On behalf of what organization are you submitting this form?
*
required
Please select the school in which you would like to submit a formal request for Reconsideration of Library Collection Materials.
*
required
Arlington Elementary School
Donelson Elementary School
Arlington Middle School
Arlington High School
Have you raised your concern with the school librarian or principal prior to filing this request?
Yes
No
Type of Media
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required
Book
Magazine
Newspaper
Other
What is the title of the item in question?
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required
Publisher or Producer
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required
Publication Date
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required
Did you read, view, or listen to the complete item? Note: The committee will judge the item on its merits as an entire piece, not by portions or out-of-context selections.
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required
Yes
No
How was the item acquired?
*
required
On-Site School Library
Online Catalog (eBook, audiobook, etc.)
Classroom
Is the item part of a set or series?
*
required
Yes
No
I'm Unsure
What is objectionable regarding this item and why? Please explain why you feel the selection is not appropriate for the age and maturity level of the student and why the selection is not suitable or consistent with the educational mission of the school. (Be specific by citing page numbers or passages)
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required
0 / 2000
Have you reviewed any professional educational journals or educational online reviews in reference to the item listed?
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required
Yes
No
If yes, what was shared through the journals or online reviews?
Do you feel there is any educational value to this item?
*
required
Yes
No
Please explain why you selected either “yes” or “no” to the previous question.
*
required
0 / 2000
What do you suggest be provided to replace the item in question?
*
required
0 / 2000
Please type your full name to sign this request electronically, and then press submit.
*
required
Submit