GCSD Materials Review Request Form
Submit a request to review sensitive materials and share the evidence and requested action.
Title of material
*
Author
*
School
*
Please Select
Antimony Elementary
Boulder Elementary
Bryce Valley Elementary
Bryce Valley High
Escalante Elementary
Escalante High
Panguitch Elementary
Panguitch Middle
Panguitch High
Garfield Online
Requestor name
*
Requestor contact information
*
Requestor role
*
Parent of a student at the school
Student at the school
School employee
Child enrollment status at this school (if applicable)
Location where the material was accessed (e.g., library, classroom)
*
Concerns and evidence
*
Requested action
*
Restrict access
Remove
Other — describe below
Additional comments
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Request
Submit Request
Should be Empty: