Challenged Materials Form

1. Date Submitted *This question is required. This question requires a valid date format of MM/DD/YYYY.

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2. Title of Work *This question is required.

3. Format of Material: *This question is required.

4. Author(s) *This question is required.

5. Date of Publication *This question is required. This question requires a valid date format of MM/DD/YYYY.

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6. Call Number *This question is required.

7. Barcode: *This question is required.

8. Name of Complainant Initiating Request *This question is required.

9. Mailing Address *This question is required.

10. Day Telephone *This question is required.

11. Email Address *This question is required. This question requires a valid email address.

13. Name of Organization (enter N/A if not applicable) *This question is required.

14. President/Primary Officer of Organization (enter N/A if not applicable) *This question is required.

15. Mailing Address of Organization (enter N/A if not applicable) *This question is required.

16. Why does this resource not fall within the collection development policy of Molstead Library? Point to specific criteria of the collection development policy. *This question is required.

17. To what in the work do you object? Be specific, cite page numbers and quote exact passages; cite specific scenes and when they occur (provide time stamp if available) in the video; cite specific lyrics or words and when or where they are found in any audio. *This question is required.

18. Did you read, view, or listen to the entire work? If not, what parts did you read? Be specific, cite page numbers, chapters, scenes, sections, tracks, etc. *This question is required.

19. In your personal opinion what do you feel might be the result of reading, watching, or listening to this work? On what do you base this opinion? *This question is required.

20. If the work purports to be a work of nonfiction, what inaccuracies in the text, pictures, or content did you observe? Be specific as to dates, persons, historical content, legal, medical information, etc., citing specific examples and page numbers. *This question is required.

21. Are you aware of judgements of this work by literary critics and/or subject specialists? What reviews have you researched? Give specific citations. *This question is required.

22. In its place, what work would you recommend that would equally convey as valuable a picture and perspective of the subject treated? List specific titles and their authors. Materials must cover the same subject matter, and out of print publications may not be suggested. *This question is required.