Materials Reconsideration Form

The Kitchener Public Library, recognizing that it serves a varied community with a wide diversity of tastes and convictions, welcomes expressions of concern about the contents of items held in its collection.

We ask you to please complete all sections of the form below so that we can fully understand your specific concerns regarding the item. Once the form has been completed, please drop it off at any service desk at your nearest KPL location. The item in question will be submitted for review. Library professionals will evaluate the item and examine published reviews assessing its merit.

You will receive a written reply detailing the Library's considered decision and any action that may have resulted from your request as soon as possible.

Please print off and complete the form below
(use a seperate sheet if necessary)

DATE: ________________________

TITLE: ______________________________________________________

AUTHOR: ___________________________________________________

PUBLISHER: ________________________________________________

TYPE OF MATERIAL: _________________________________________

YOUR NAME: ________________________________________________

ADDRESS: __________________________________________________

E-MAIL: _____________________________________________________

TELEPHONE: ( ....) ________________

ARE YOU SPEAKING FOR:

a) Yourself ......................b)Organization (Name)

1. What concerns do you have about this work?

2. Are there specific pages/sections to which you object?

3. Did you read, see or listen to the entire work? a)Yes ... b) No

4. Have you seen/heard any promotions or read any reviews about this work? If so, please identify.

5. Are there any additional comments you would like to make?