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Vol 2 No. 1170 A.C. D.C. 1867

[[preprinted]] [ED. FORM NO. 4.)

TEACHER'S MONTHLY
SCHOOL REPORT.

For month of [[dotted line]] 186  .
District or County [[dotted line]]
State, [[dotted line]]
Name of School, [[dotted line]]
Name of Teacher, [[dotted line]] [[/preprinted]]

C84. R.F.& A.L. Vol 9. 1867,

[[preprinted]] Forwarded [[dotted line]]
Received [[dotted line]]

EXPLANATIONS.

The accompanying Blanks is a copy of the Bureau Superintendent's Blank placed in columnar form for the sake of simplicity and to reserve entire uniformity.
It is hoped that the Educational Associations will adopt this blank, or one which will contain these questions. (Should this exact form be adopted the Bureau can furnish the blanks).
If any question cannot be answered by the teacher, it may be left for their Superintendent. Place each answer, to the extent of yourknowledge, opposite the question and he will fill the remaining spaces.
It is supposed that no teacher has more than one day and one night school, or but one of either.
Night and Sabbath schools taught by a group of teachers should be reported but once.
The question, "when opened?" has reference to the present season.
The above explanations are deemed necessary where this blank is adopted by the Associations.
[[image: hand with index finger pointing to right]] Should more extended forms be used, it would oblige the Commissioner to have them include all the items of this.

Bureau R. F. &. A L., Washington, D. C., Oct. 1, 1866.