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Escondido Union HSD  |  E  1312.2  Community Relations

Complaints Concerning Instructional Materials   

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Citizen's Request for Reconsideration of Instructional Materials

Date____________________________________

TITLE:___________________________________

AUTHOR:_________________________________

PUBLISHER:_______________________________

DATE OF EDITION:__________________________

Request received by:________________________

Title:____________________________________

Citizen's Name:_____________Phone:__________

Citizen Represents: Himself/Herself____________

Organization or Group

1. To what do you object? (Please be specific: cite pages, tape sequence, video frame, and words)

2. What do you feel would be the result of reading/viewing this material?

3. For what age group would you recommend this material?

4. Did you read/view the entire selection?

5. If not, what percentage did you read/view, or what parts?

6. Is there anything good about this material?

7. What would you like the school to do about this material?

Do not assign it to my child.

Withdraw it from all students.

Re-evaluate it.

8. Are you aware of how this work has been assessed by literary critics?

9. What do you believe is the thesis of this work?

10. In its place, what work would you recommend?

____________________________

Signature of citizen

Action taken __________________Date______________

ESCONDIDO UNION HIGH SCHOOL DISTRICT

Escondido, California