Request for Reconsideration of Library Material Have you read Henika District Library’s Collection Development Policy?(if no, please ask for a copy from the front desk before submitting this request) (required) Yes No Have you read the Library Bill of Rights and the Intellectual Freedom Statement of the American Library Association?(if no, please ask for a copy from the front desk before submitting this request) (required) Yes No Author/Performer (required) Title (required) Format (book, CD, DVD, etc.) (required) How did this material come to your attention? (required) Have you experienced the entire work? (required) Yes No Are you objecting to the entire work? (required) Yes No What is your objection to the work? (Please be specific; cite pages, passages.) (required) If this material is removed from the library, would you suggest an alternative work? Please include an explanation of why you believe this alternative work would be better suited for our collection. (required) Patron’s Name (required) Address (required) Telephone Number (required) Email (required) Date (required) Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
