1312/6161.12 Form #2 1312/6161.12 Form #2Checklist for School Media Advisory Committee's Reconsideration of
Instructional Material - Nonfiction (sample)
Title __________________________________________________Author _________________
A. Purpose
1. What is the overall purpose of the material? ______________________________
________________________________________________________________________
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2. Is the purpose accomplished? ___Yes ___No
B. Authenticity
1. Is the author competent and qualified in the field? ___Yes ___No
2. What is the reputation and significance of the author and publisher/producer in the field?
_________________________________________________________
_________________________________________________________________
C. Appropriateness
1. Does the material promote the educational goals and objectives of the curriculum of District Schools? ___Yes ___No
2. Is it appropriate to the level of instruction intended? ___Yes ___No
3. Are the illustrations appropriate to the subject and age levels? ___Yes ___No
D. Content
1. Is the content of this material well presented by providing adequate scope, range, depth and continuity? ___Yes ___No
2. Does the material present information not otherwise available? ___Yes ___No
3. Does the material give a new dimension or direction to its subject? ___Yes ___No
E. Reviews
1. Source of review: ___________________________________________________
Favorably received _______Unfavorably received _______
2. Does this title appear in one or more reputable selection aids? ___Yes ___No
If answer is yes, please list titles of selection aids. ___________________________
__________________________________________________________________
Additional Comments:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Recommendation by School Media Advisory Committee for Treatment of Challenged Materials
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Date _____________________________________
Signature of Media Advisory Review Committee
____________________________________ ____________________________________
____________________________________ ____________________________________