Challenge Form
Statement of Concern about Library Resources
Texas County Library
Name__________________________________________ Date___________________
Address________________________________________ Phone__________________
City_____________________________ State___________________ Zip____________
Resource on which you are commenting:
______ Book ______ Audio-Visual Resource
______ Display ______ Content of Library Program
______ Newspaper ______ Other
Title:___________________________________________________________________
Author/Publisher or Producer/Date: __________________________________________
1. Have you read the Texas County Library Collection Policy?
2. What brought this resource to your attention?
3. To what do you object? Please be as specific as possible.
4. Have you read or listened or viewed the entire content? If not, what parts?
5. What do you feel the effect of the material might be?
6. What age group would you recommend this material??
7. What do you want the library to do with this material?
Signature _______________ Date __________ Card# ___________________