Book Challenge Reporting Form
Submit details about your book challenge and upload documents; district response and appeal questions will appear only if applicable.
Contact Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
State
*
Role
*
Please Select
Parent
Guardian
Student
Teacher
Community Member
Other
School and District Information
School Name
*
School District
*
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Book Information
Book Title
*
Challenge Details
Date Challenge Submitted
*
-
Month
-
Day
Year
Date
Submitted By
*
First Name
Middle Name
Last Name
Was the District’s Official Reconsideration Policy Followed?
*
Yes
No
Not Sure
Received By (Name or Title)
*
Reason for Challenge
*
Supporting Documents
Copy of Submitted Challenge or Reconsideration Form
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Excerpts or Page Images
Upload a File
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of
Correspondence with School Officials
Upload a File
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of
Other Supporting Documents
Upload a File
Drag and drop files here
Choose a file
Cancel
of
District Response
Has a district response been received?
*
Yes
No
Pending
Not applicable
Date district response was received
-
Month
-
Day
Year
Date
District decision
*
Please Select
Removed
Restricted
Retained
Relocated
Access changed
Pending
Other
What actions were taken?
Removed
Restricted
Retained
Relocated
Access changed
Decision pending
No action taken
District response summary
Upload district written response
*
Upload a File
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Choose a file
Cancel
of
District response reference number
Appeal and Public Process
Was an appeal filed?
*
Yes
No
Appeal date
-
Month
-
Day
Year
Date
Appeal status
Please Select
Pending
Under review
Resolved
Withdrawn
Denied
Other
Was the issue addressed at a school board meeting?
Yes
No
School board meeting date
-
Month
-
Day
Year
Date
Link to agenda or video
Did the person speak during public comment?
Yes
No
Not sure
Outcome and Follow-Up
Final outcome
*
Please Select
Challenge upheld
Challenge denied
Partially upheld
Pending further review
Resolved informally
Other
Follow-up assistance needed
Appeal assistance
Public records request
Policy review
Media support
Next steps guidance
Other
Additional details
Permissions
I authorize the organization to contact me about this submission
*
Option 1
Option 2
Option 3
I allow my information to be used in an anonymous national tracking database
Option 1
Option 2
Option 3
I allow my name and story to be shared publicly
Option 1
Option 2
Option 3
Submit Report
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