Statement of Concern Form

Please read our S tatement of Concern Policy prior to submitting this form. Response to requests may take up to 60 days.

Fields marked with * are required.

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Are you a Madison County Resident? *

Yes

In order to submit a Statement of Concern, you must be a resident of Madison County.

Title: *

Type of Library Material: *

Author (Composer / Director): *

Publisher / Producer *

Month

Day

Year

Patron's Name: *

Patron's Address: *

Street, City, State, ZipCode

Patron's phone number: *

Patron's Email: *

Patron's library card / member number: *

What are your objections to this library material? *

What harm do you feel this material might cause? *

Did you complete the entire item? *

Yes

What parts did you complete? *

Is there anything worthwhile in this material? *

Have you read any professional reviews of this item? *

Yes

Please list the reviews you read: *

What do you believe are the main ideas of this material? *

What do you think was the writer’s/composer’s/director's intention in creating this work? *

What material with a similar purpose would you suggest as a replacement for this item? *

Additional comments:

About

This is the public’s library. Huntsville-Madison County Public Library (HMCPL) is a nonprofit 10-branch system that serves all of Madison County, Ala. For 200 years, the library has been dedicated to enriching the educational, recreational and cultural lives of communities in Madison County through materials, information and programs that foster a lifelong love of learning.

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Statement of Concern Form

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Statement of Concern Form

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