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Policy IJJ-E-2
This Report Should Be Completed By The Person Responding To A Challenge To Materials And Resources (Policy Ijj.) The Information From This Form May Be Shared With Maine Association Of School Libraries And The American Library Association To Track Trends In Materials Challenges.
Staff Member Completing Form: ____________________________________________________________
Email: _______________________________________________________________________________________
Role: ________________________________________________________________________________________
What Are You Reporting?
Materials Challenge (Books, Movies, Magazines, Digital Content)
Internet-Related Challenge (Filtering Issues, Access To Computers, Use Policies) School Environment (Library, Meeting Rooms, Programs, Author Visits, Exhibits, Displays, Hold Shelf Practices)
Other (Student Publications Or Performances, Access To Libraries, Social Media, Artwork, “First Amendment Audit”)
If The Previous Response Is “Materials Challenge”:
Title: ____________________________________________________________________________________
Author Or Performer: ____________________________________________________________________
Type Of Item: ____________________________________________________________________________
Please Describe The Incident.
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
When Did This Happen?
______________________________________________________________________________________________________________
Who Initiated The Challenge Or Raised The Issue? :
Name: __________________________________________________________________________________
Address: ________________________________________________________________________________
Phone: __________________________________________________________________________________
Email: ___________________________________________________________________________________
Relationship To School:
Parent/Guardian
Student
Employee
Community Member
Why Did The Initiator Say This Was A Concern? (Attach The Completed “Request For Reconsideration Of Materials” (Ijj - E-1))
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Where Did This Happen?
School: ____________________________________________________________
Address: ___________________________________________________________
Where Did The Issue Or Challenge Occur?
Classroom
Library
School Curriculum
Other ________________________________________________
Completed Incident Report Forms Should Be Given To The Building Principal Where The Challenged Material Can Be Found. (Adapted From American Library Association’s Challenge Material Form. Https://Www.Ala.Org/Tools/Challengesupport/Report)
*Please excuse any formatting errors.
