Request for Reconsideration Form Please fill out all fields before submitting Library Card Number: Full Name: Street Address: Apt # (optional): City: State: Zip Code: Telephone: Email: Media type: BookDVDCDeBookAudiobookeAudiobook Title: Author or Artist: Did you read, view or listen to the entire work? YesNo What are your concerns? What do you feel might result of reading, viewing or listening to this item? Is there anything good about the material? Are you aware of the judgment from professional reviewers on this item? What brought this title to your attention? Proposed action Δ