Reader's Name:

Age:

Advisor's name:

Library:

Title:

Author:

Publisher:

Publication Date:

Galley?
yes
no

Did the cover inspire you to pick up the book?
yes
no

Did the cover reflect the contents of the book?
yes
no

Would you recommend this book to a friend?
yes
no

If yes, what would you say to convince him or her to read it?

Describe the most compelling aspect of this book:

Were you disappointed with this book?
yes
no

Why or why not?

Did you finish this book?
yes
no

Check all the age ranges of readers suited for this book.
Under 12
12 - 13
14 - 15
16 - 17
17 - 18
18 and up

How would you rate this book on quality with 5Q being the best?
5Q Hard to imagine a better book.
4Q Better than most.
3Q Readable.
2Q Needs more work.
1Q How did it get published?

How would you rate this book on popularity with 5P being the best?
5P Everyone wants to read it.
4P Broad general teen appeal.
3P Some teen appeal.
2P Only for special interest.
1P Yech! Forced to read it!

If you rated this book a 4 or 5 above, it might be worth nominating.  Would you like to nominate this book?
yes
no

If you nominated this book for Teens' Top Ten, what made it special enough to qualify :

If you decided not to nominate this book, what made it fall short?

Please list any additional comments you have: