630E2 - Reconsideration of Instructional Materials

 

EDUCATIONAL PROGRAM

Series 600

Policy Title:           Reconsideration of Instructional Materials                            Code No.:  630E2 

 

RECONSIDERATION OF INSTRUCTIONAL AND MEDIA CENTER MATERIALS REQUEST FORM

 

Request for re-evaluation of printed or multimedia material to be submitted to the superintendent.

 

REVIEW INITIATED BY: DATE: __________________

 

Name _________________________________________________________________________

 

Address _______________________________________________________________________

 

City/State ________________________________ Zip Code _______ Telephone _____________

 

School(s) in which item is used _____________________________________________________

 

Relationship to school (parent, student, citizen, etc.) _____________________________________

 

BOOK OR OTHER PRINTED MATERIAL IF APPLICABLE:

 

Author _________________________ Hardcover_______Paperback______Other______________

 

Title ____________________________________________________________________________

 

Publisher (if known) ________________________________________________________________

 

Date of Publication _________________________________________________________________

 

MULTIMEDIA MATERIAL IF APPLICABLE:

 

Title _____________________________________________________________________________

 

Producer (if known) _________________________________________________________________

 

Type of material (website, online resource, filmstrip, motion picture, etc.) __________________________________________________________________________________

 

PERSON MAKING THE REQUEST REPRESENTS: (circle one)

 

Self Group or Organization

 

Name of group _____________________________________________________________________

 

Address of Group___________________________________________________________________

 

 

RECONSIDERATION OF INSTRUCTIONAL AND MEDIA CENTER MATERIALS REQUEST FORM

 

 

1. What brought this item to your attention?

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

2. To what in the item do you object? (please be specific; cite pages, or frames, etc.)

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

3. In your opinion, what harmful effects upon students might result from use of this item?

_________________________________________________________________________________

 

_________________________________________________________________________________

 

4. Do you perceive any instructional value in the use of this item?

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

5. Did you review the entire item? If not, what sections did you review?

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

6. Should the opinion of any additional experts in the field be considered?

 

______yes ______no

 

If yes, please list specific suggestions:

_________________________________________________________________________________

 

_________________________________________________________________________________

 

7. To replace this item, do you recommend other material which you consider to be of equal or superior quality for the purpose intended?

 

 

_________________________________________________________________________________

 

_________________________________________________________________________________