TexQuest Program - Request for Reconsideration Form

Your Name

Address

State

ZIP

Phone

E-mail

Date

	Do you represent an organization?
	Yes
	No

If yes, provide the organization name:

1. Resource (specific article, eBook, or publication) for which you are requesting reconsideration:

Title

Author/Creator

	2. How did you access this resource (specific article, eBook, or publication)?
	Campus/School District
	Home

If Home, what website?

3. What brought this resource (specific article, eBook, or publication) to your attention?

	4. Please describe the resource content (specific article, eBook, or publication) you reviewed:
	Entire Work
	Particular sections or chapters

If particular sections, please list:

5. What specific concerns do you have about the resource (specific article, eBook, or publication)?

6. List any resource(s) that can provide additional information related to your request and/or other viewpoints on the topic(s) addressed by this book.

7. What action(s) are you requesting that the program consider?

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