Request for Reconsideration of Library Programs

Program title

Program date and location

Your name

Address

City/Town

Province

Postal Code

Phone number

Library card barcode number

If this request is made on behalf of an organization or group, please identify the organization or group

I have read the Whitby Public Library’s Program Policy

Yes

No

Please describe your concerns/objections to this program:

What do you feel might be the result of attendance at this program?

Any additional comments?

This item will be reviewed by a program committee, and you will be informed of its decision.