J. Robert Jamerson Memorial Library

Collection

Author

Publisher (if known)

Title

Form of material (e.g., book, video, recording, etc.)

Request initiated by

Address

City

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Whom do you represent?

☐ Myself

☐ Organization (Please specify)

☐ Other (Please specify)

Did you read, see, listen to, or otherwise use the material in its entirety?

☐ Yes

☐ No (if not, then which parts?)

Have you seen or heard reviews of this material?

☐ Yes (if yes, please name the source)

☐ No

What do you think the material is about?

To what in the work do you object? (Please be specific.)

What do you feel might be the result of reading, viewing, or hearing this work?

For what age group would you recommend this work?

Is there anything good about the work?

What would you like your library to do about this material?

In its place, what work would you recommend that would convey as valuable a picture and perspective of the subjected treated?

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Date

Thank you for your interest in the Library. Your comments will be forwarded to the Library Director.