The document is a request form for reconsideration of instructional materials in the Harrison County Schools. It collects information about the material being requested for reconsideration such as format, author, title, and publisher. It asks the complainant to identify themselves and whether they represent themselves, an organization, or other group. It then asks a series of questions for the complainant to answer after reviewing the material in full, including what they object to in the material, their understanding of its theme or purpose, potential results of a student using it, recommended age group, whether there is anything good in the material, and recommendations for alternative instructional materials covering the same subject and format. The complainant must sign and date the completed form.
The document is a request form for reconsideration of instructional materials in the Harrison County Schools. It collects information about the material being requested for reconsideration such as format, author, title, and publisher. It asks the complainant to identify themselves and whether they represent themselves, an organization, or other group. It then asks a series of questions for the complainant to answer after reviewing the material in full, including what they object to in the material, their understanding of its theme or purpose, potential results of a student using it, recommended age group, whether there is anything good in the material, and recommendations for alternative instructional materials covering the same subject and format. The complainant must sign and date the completed form.
The document is a request form for reconsideration of instructional materials in the Harrison County Schools. It collects information about the material being requested for reconsideration such as format, author, title, and publisher. It asks the complainant to identify themselves and whether they represent themselves, an organization, or other group. It then asks a series of questions for the complainant to answer after reviewing the material in full, including what they object to in the material, their understanding of its theme or purpose, potential results of a student using it, recommended age group, whether there is anything good in the material, and recommendations for alternative instructional materials covering the same subject and format. The complainant must sign and date the completed form.
SCHOOL: _____________________________________________________________ Format of Material: _____________________ Author: __________________________ Title: _____________________________ Publisher/Producer: ___________________ Request initiated by: _________________________ Telephone: __________________ Address: ____________________________ City/State/Zip: ______________________ Complainant represents: ____Himself ____ Organization (Name) ___________________________ ____ Other Group (Name) ___________________________ The following questions are to be answered after the complainant has read, viewed, or listened to the material in its entirety. If sufficient space is not provided, attach additional sheets. Please sign each additional attachment. What do you object to in the material? (Please be specific.) ______________________________________________________________________ ______________________________________________________________________ What do you believe is the theme or purpose of this material? ______________________________________________________________________ ______________________________________________________________________ What do you feel might be the result of a student using this material? ______________________________________________________________________ ______________________________________________________________________ For what age group would you recommend this material? ______________________________________________________________________ ______________________________________________________________________ Is there anything good in this material? _______ Please comment: ______________________________________________________________________ ______________________________________________________________________ Would you care to recommend other instructional material of the same subject and format? ______________________________________________________________________ ______________________________________________________________________
__________________________________ Signature of Complainant Reviewed by Board: