Challenge Form

Statement of Concern about Library Resources

Texas County Library

Name__________________________________________ Date___________________

Address________________________________________  Phone__________________

City_____________________________ State___________________ Zip____________

Resource on which you are commenting:

______ Book ______ Audio-Visual Resource

______ Display ______ Content of Library Program

______ Newspaper ______ Other


Author/Publisher or Producer/Date: __________________________________________

1.  Have you read the Texas County Library Collection Policy?

2.  What brought this resource to your attention?

3.  To what do you object?  Please be as specific as possible.

4.  Have you read or listened or viewed the entire content?  If not, what parts?

5.  What do you feel the effect of the material might be?

6.  What age group would you recommend this material??

7.  What do you want the library to do with this material?

Signature _______________   Date __________  Card# ___________________