North Carolina School Challenge Form
Please report school library material or curriculum challenges to NCSLMA using this form. The only required information to submit this form is the title and county. All other information is optional. We will not contact you unless you request it.
Material Information
Title *
Your answer
Author
Your answer
Copyright/Publication Date
Use January 1 if you only know the year. Use the first of the month if you only know the month.
MM
/
DD
/
YYYY
Publisher
Your answer
Material Format
Type of material
Reason for Challenge
Why was the material challenged?
Please check all that apply.
Challenge Initiator
Who initiated the challenge?
Please check all that apply.
Date of Challenge
Use January 1 if you only know the year. Use the first of the month if you only know the month.
MM
/
DD
/
YYYY
Status of Material
What is the current status of the challenged material?
Please check all that apply.
Who decided or changed the status of the material?
Media Coverage
Has this challenge appeared in any media outlet?
If applicable, please select the media outlet(s) in which the challenge appeared.
If applicable, please provide identifying information for the media outlet in which this challenge appeared.
Include URL, radio or TV station call letters, name/address of news organization, title/issue of magazine or newspaper, as well as a date and brief summary if possible.
Your answer
School Information
County *
School Type
School Level
School Name
Your answer
School Address
Your answer
School Phone Number
Your answer
School Website
Your answer
Contact Information
Providing this information is optional. If you choose to provide this information, it will not be made public. You will only be contacted if you request it. You may choose to answer all, some, or none of these questions.
First & Last Name
Your answer
Phone Number
Your answer
Email Address
Your answer
Your Title/Position
Have you reported this challenge to ALA?
Would you like a member of NCSLMA to contact you concerning this challenge?
If you answered yes to the above question, please choose your preferred method of contact.
Comments or additional information.
Your answer
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