1. Name:_______________________________
2. Address _____________________________
City ____________________ State ________ Zip _________
3. Phone:___________________
4. Complainant represents:
a.) Personal ____
b) Organization (name): __________________
5. Type of material? (Book, DVD, etc.) ____________________________________
6. Title: _________________________________________
7. Author: _______________________________________
8. Did you read/watch/listen to the entire work? ____Yes ____No
9. If not, which part(s)?: ________________________________________________________
10. What concerns you about this material? (Please be specific; cite pages) ______________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________
11. Is there anything positive about the item in question? ____________________________________________________________________________________________________________________________________________________________________________________
12. What action do you think the Library should take in regard to this material? ___________________________________________________________________________ ___________________________________________________________________________
Signature of complainant: __________________________ Date______________________
I was given a copy of the Materials Selection / Acquisitions Development Policy. Yes __ No ___
Policies
- Anti-Discrimination Policy
- Anti-Harassment Policy
- Circulation and Interlibrary Loans Policy
- Citizen’s Request for Review of Library Materials
- Community Meeting Room Policy
- Conflict of Interest Policy – Officers, Board Members and Employees
- Cost of Services Policy
- Disaster Policy
- Display and Exhibits Policy
- Employee Handbook
- Freedom to Read Statement
- Interlibrary NCLS/Due North Loans Policy
- Internet, WiFi, and Computer Use Policy
- Library Photography and Video Policy
- Links from the Library’s Website
- Materials and Monetary Donations Policy
- Materials Selection/Acquisitions Development Policy
- Operation Policy
- Patron Behavior Policy
- Patron Confidentiality Policy
- Preservation and Conservation of Library Materials Policy
- Programming and Event Policy
- Public Employer Health Emergency Plan for Hepburn Library of Madrid
- Public Notice Bulletin Board Policy
- Public Relations Policy
- Sexual Harassment Policy
- Social Media Policy
- Strategic and Long Range Plan for Hepburn Library of Madrid
- Tobacco Use Policy
- Trustee Education Policy
- Volunteer Policy
- Whistleblower and Ethical Behavior Policy