SCHOOL DISTRICT NO. 67 (OKANAGAN SKAHA) REQUEST FOR RECONSIDERATION OF LEARNING RESOURCES (With reference to School District No. 67 Policy #470) Title of Work Author/Publisher/Supplier Type of Material Request initiated by Telephone __________ _____ _____ _____ _____ Address _____ Complainant represents ( ) Himself / Herself ( ) (Name of organization or group) 1. _____ Why do you object to the work? Please be as specific as possible. _____ _____ _____ _____ _____ 2. Do you see any value in the work? _____ _____ 3. Have you read the entire book? _____ 4. What would you prefer the school do about this work? ( ) do not recommend or assign it to my child ( ) withdraw it from all students 5. Can you recommend other works of equal value that would serve the same purpose? _____ _____ Date: _____ (Signature of Complainant) Ref: 00650-20 Request For Reconsideration of Learning Resources; LW 2001-03-21; Print: White