Request for Reconsideration for School Library Books (OLD)

This form is used by a parent or resident of this county to submit an objection for the following material:

Materials used in a classroom in the district, except for instructional materials as defined in s. 1006.29(2), F.S. The process and forms to object to instructional materials can be found https://www.stlucie.k12.fl.us/pdf/forms/CUR0049.pdf.
Materials made available to students in a school or classroom library.
Materials included on a school or classroom reading list.

For additional information, about our objection form please contact Denise Rodriguez at (772) 429-7524.

Section 1: Parent or Resident Information

Check the box that applies to you.

Parent/Guardian

Resident of this County

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Section 2: Information Regarding Material

Type of material:

Book

Non-print material

Other

Other (Identify)

Title of the Material

Author of Material

Publisher or Producer

Grade Level Used

Where is the material found:

Media Center

Classroom Library

Reading List

Other

Other (Identify)

School(s) where material is found:

ISBN, if available

Section 3: Basis for the Objection

Identify the basis for your objection:

The material is pornographic.

The material is prohibited under Section 847.012, F.S.

The material depicts or describes sexual conduct as defined in Section 847.001(19), F.S.

The material is not suited to student needs and their ability to comprehend the material.

The material is inappropriate for the grade level and age group for which it is used.

What brought this material to your attention?

Did you examine this material in its entirety?

Yes

If not, what sections did you examine?

Identify the portion of the material objected to and why. (You must be specific and provide page numbers, sections, or timestamps, as appropriate.

Is there any age or grade you would recommend this material?

Yes

If yes, please specify

Is there any value in this material?

What is your desired outcome for this material?

Remove or discontinue use of material

Limit access to certain grade levels.

Limit my child's access

Other

Other (Identify)

Signature

Sign Here

Date / Time

Some description about this section