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630E2 Reconsideration of Instructional Materials

EDUCATIONAL PROGRAM

 

Series 600

 

Policy Title:    Reconsideration Of Instructional Materials           

Code No.:      630.E2

 

RECONSIDERATION REQUEST FORM

Request for re-evaluation of printed or audiovisual material to be submitted to the superintendent/designee.

 

REVIEW INITIATED BY:

 

DATE:

 
           

Name

         
           

Address

         
           

City/State

 

Zip Code

 

Telephone

 
           

School(s) in which item is used

     
           

Relationship to school (parent, student, citizen, etc.)

   
           

BOOK OR OTHER PRINTED MATERIAL IF APPLICABLE:

           

Author

 

Hardcover

 

Paperback

 

Other

 
           

Title

         
           

Publisher (if known)

         
           

Date of Publication

         
           
           

AUDIOVISUAL MATERIAL IF APPLICABLE:

           

Title

         
           

Producer (if known)

         
           
 

Type of material (instructional video, motion picture, etc.

     
           
           

PERSON MAKING THE REQUEST REPRESENTS: (circle one)

           
 

Self

 

Group or Organization

 
           
 

Name of group

       
           
 

Address of Group

       

 

Reconsideration Of Instructional Materials                                     Code No. 630.E2                                                                                Pg. 2Code No.  630.E2

 

RECONSIDERATION OF INSTRUCTIONAL MATERIALS

 

1.

What brought this item to your attention?

           
           
           
           
           
           

2.

To what in the item do you object?  (please be specific; cite pages, timestamp, or frames, etc.)

           
           
           
           
           

3.

In your opinion, what harmful effects upon students might result from use of this item?

           
           
           
           
           

4.

Do you perceive any instructional value in the use of this item?

           
           
           
           
           

5.

Did you review the entire item?  If not, what sections did you review?

           
           
           
           
           

6.

Should the opinion of any additional experts in the field be considered?

           
     

yes

 

no

 

 

Reconsideration Of Instructional Materials                        Code No. 630.E2                                                                                Pg. 3

       
 

If yes, please list specific suggestions:

   
           
           
           

7.

To replace this item, do you recommend other material which you consider to be of equal or superior quality for the purpose intended?

           
           
           

 

8.

Do you wish to make an oral presentation to the Review Committee?

             
   

Yes

(a)    Please call the office of the Superintendent and/or designee

             
             
     

(b)    Please be prepared at this time to indicate the approximate length of time your presentation will require.

           

Minutes.

             
   

No

       
             
             
             
         
 

Dated

 

Signature

 

                                           Pg. 2

 

 

Reconsideration Of Instructional Materials                                     Code No. 630.E2                                                                                Pg. 4