The trustees of Ogdensburg Public Library have established a materials selection policy and a procedure for gathering input about particular items. Completion of this form is the first step in that procedure. If you wish to request reconsideration of a resource, please return the completed form to the library director.

Date ______________________
Name ______________________________________________________________
Address ____________________________________________________________
City ___________________________    State ______________  Zip ____________

Phone ____________________________     Email __________________________

Do you represent yourself? ____ Or an organization? ____

Name of Organization________________________________________________

1. Resource on which you are commenting:
___ Book (e-book)
___ Movie
___ Magazine
___ Audio Recording
___ Digital Resource
___ Game
___ Newspaper
___ Other



2. What brought this resource to your attention?

3. Have you examined the entire resource? If not, what pages did you review?

4. Tell me what page(s) or chapter concerns you?  Chapter mark, minute mark or scene in audiobooks?  For movies what scenes or what part of the movie?

5. Are there resource(s) you suggest to provide additional information and/or other viewpoints on this topic?

6. What action are you requesting the committee to consider?

Reviewed and no action ________ Date________

Reviewed and sent to trustees ________ Date ________

Reviewed and response to sender ________ Date ________