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Request for Reconsideration of Material Form <br />The Pleasanton Public Library has established a procedure for gathering input about a specific <br />material. Completion of this form is the first step in that procedure. If you wish to request <br />reconsideration of a material, please return the completed form to the library. <br />Pleasanton Public Library | 400 Old Bernal Ave. Pleasanton, CA 94566 <br />Date <br />Name <br />Address <br />City State/Zip <br />Phone Email <br />Do you represent self? Or an organization? Name of Organization <br />1.Material on which you are commenting: <br />Book (e-book) Magazine Digital Resource __Newspaper <br />Movie Audio Recording Game Other <br />Title <br />Author <br />Have you examined the entire material? ___Yes ___No <br />2.What brought this material to your attention? <br />3.What concerns you about the material? <br />4. Are there material(s) you suggest providing for additional information and/or other <br />viewpoints on this topic? <br />ATTACHMENT  <br />Page 152 of 376