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REQUEST FOR RECONSIDERATION OF INSTRUCTIONAL RESOURCES EF(EXHIBIT A)
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Address
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Your answer
City
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Your answer
State
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Your answer
Zip code
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Your answer
Who do you represent?
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Yourself
An organization
If representing an organization, please identify:
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Resource on which you are commenting
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Book
Magazine
Newspaper
Audio recording
Video recording
Textbook
Library program
Display
Digital Resource
Campus Location of Resource(s)
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Bee Cave Elementary
Lake Pointe Elementary
Lake Travis Elementary
Lakeway Elementary
Rough Hollow Elementary
Serene Hills Elementary
West Cypress Hills Elementary
Bee Cave Middle School
Hudson Bend Middle School
Lake Travis Middle School
Lake Travis High School
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Resource Title
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Your answer
Author/Producer
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Your answer
Have you reviewed the entire resource?
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Yes
No (If not, please do so before completing and submitting this form.)
To what in the resource do you object? (Please be specific and cite pages or specific times for digital resources.)
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What do you believe might be the result of using this resource?
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For what age group would you recommend this resource?
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In its place, what resource of equal quality would you recommend that could be used to teach similar subject matter?
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Is this a library resource?
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Yes
No
Is this a classroom curriculum resource?
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Yes
No
Additional Comments
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Complainant's Digital Signature
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Date
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MM
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YYYY
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