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Lancaster SD |  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: ___________________________

Exhibit LANCASTER SCHOOL DISTRICT

version: November 6, 2007 Lancaster, California