小丑撸

小丑撸 Book and Media Materials Access

The survey will take approximately 4 minutes to complete.

1. Student's Legal First and Last Name:

2. Student's School Name:

3. Student's ID Number:

4. Choose your child's access level

• Unlimited
  
  
• Limited (see my objections below)
  
  
• No Access (student is not permitted to access books from the media center and classroom libraries)

5. If you selected limited access, choose which book genre(s) you do NOT want your child to access

• Nonfiction Biographies
  
  
• Autobiographies
  
  
• Nonfiction
  
  
• Fantasy
  
  
• Mystery and Suspense
  
  
• Realistic Fiction
  
  
• Social Studies
  
  
• Technology
  
  
• Arts and Recreation
  
  
• History and Geography
  
  
• Young Adult Fiction
  
  
• Poetry
  
  
• Graphic Novels

Other - Please list any additions ________________________________________________________

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6. Parent’s Name:

7. Parent’s Contact Number:

8. Parent’s Email Address: