I-H (FORM A),12/11/89

PFLUGERVILLE I.S.D.
INSTRUCTIONAL RESOURCES: INSTRUCTIONAL MATERIALS AND ADOPTION 
EXHIBIT A ___________________________________________________________I.S.D.
CITIZEN'S REQUEST FOR RECONSIDERATION OF INSTRUCTIONAL MATERIALS

Author_____________________________________Title_____________________________________

Publisher (if known)___________________________________________________________________

Request initiated by________________________________________________________________

Street Address____________________________________________________________________

Complainant represents:

Himself

Organization

_____________________________________________________________

OtherGroup

_____________________________________________________________

1. If a book, did you read the entire book? (or view entire film?) If not, please do so before completing and submitting this form.

2. To what in the material do you object? (Please be specific; cite pages, filmstrips etc.) ___________________________________________________________________________________

3. What do you feel might be the result of using this material ___________________________________

____________________________________________________________________________________

4. For what age group would you recommend this material?___________________________________

____________________________________________________________________________________

5. Are there any good points about this material?____________________________________________

____________________________________________________________________________________

6. Are you aware of the judgment of this material by literary critics?______________________________

___________________________________________________________________________________

7. What do you believe is the theme of this material? _________________________________________

8. In its place, what material of equal quality would you recommend that could convey as valuable a picture and perspective

of our civilization? _______________________

9. What do you feel should be done with the material in question?

Remove it from the curriculum

Do not allow my child to use this material

Use as resource material or a choice selection