Request for Program Reconsideration Form

Please complete the form below fully and be as descriptive as possible.

When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.

"*" indicates required fields

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Program Title

Date of Program:

What are your specific objections to this program?*

Have you read any reviews of this program or this speaker?*

What do you believe is the theme and/or objective of this program?*

What would you like the library to do about this program?*

What program would you recommend in its place, which would convey as valuable a picture and perspective of the subject treated?*

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