2023-2024 Elementary Novels Supplementary Nomination Form
IMPORTANT: Completion of the entire form is required before the committee can process your request. Your responses will be shared with the novels committee. Please be thoughtful in your evaluation of the criteria for adoption.
*Please be aware of the Utah law (HB 374) regarding sensitive materials; consider whether the text is age appropriate as well as making sure it would not be considered harmful to minors under Utah law.
See the definitions of sensitive materials here: https://bit.ly/3z55lMU
(Submit 1 Book per Form, if you have multiple books each book needs its own form)

(See Novels Process (highlights from Article X.A.10.)
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Email *
 Recommending Teacher (Full Name) *
Is this novel on the 4-6 grade Battle of the Books List? *
 School *
 Title of Book: *
 Author: *
 Publisher: *
 Copyright Date *
Is the book on the approved 4-6 Elementary Novels list? *
 Is the book on the Secondary Approved Novels list?  If so, use the Appeals Form to have the work approved for a new grade level and/or reviewed again (*Grade levels may reach down without approval (unless there are restrictions) and there must be 3 years between reviews)). *
 Lexile Level of text *
Reading Level of the text *
Have you recently read the entire work with a student audience in mind? *
Please Answer the following questions:
How do you plan to use this text in your instruction and is the book approved for any other grade level that you  know of?
 How do you plan to use/teach with this work  if approved? *
Targeted Grade Level
What specific qualities does this book have for students in grade 4-6? *
List the Utah ELA, Social, Studies/Science etc. Core Standards addressed by this work: *
How will the book be used to meet the Core Standards? *
The text lends itself to teaching valuable and significant lessons in the specified content area and/or in life.
The text has enough depth and richness to stimulate student thinking.
The text can be read at varying depths of meaning, including opinions/arguments, connections, points of view.
Are there any concerns (i.e. language, violence, or moral content) within this book? If so, please list them. How will you address these issues with your student?
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