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2. TITLE OF ITEM:*
4. AUTHOR OF ITEM:
6. FORMAT OF ITEM:
8. REASON FOR REQUEST
10. Why have you requested this title be evaluated for its appropriateness for the library collection?*
12. What brought this resource to your attention?*
14. Have you examined the entire resource? If not, what sections did you review?*
16. FEEDBACK
18. What is your suggestion on how to handle this item?*
20. YOUR INFORMATION
22. First Name:*
23. Last Name:*
25. Street Address:*
27. City:*
29. State:*
31. Zip Code:*
33. Mailing Address (if different from above):
35. Email:
37. Phone:
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39. 1. Receive an email copy of this form.
40. Email address

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41. Submit

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