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(Ed. Form, No. 3.)

TEACHER'S MONTHLY SCHOOL REPORT

For the Month of , 18

->To contain one entire calendar month, and to be forwarded as soon as possible after the close of the month. 
->A School under the distinct control of one Teacher, or a Teacher with one Assistant, is to be reported as one School.

[[2 columns]]

[[first column]]
[Answers placed here.]
Name of your School? private
Is it a Day or Night School? day  
When did your present session commence? 1 
Is your School supported by an Educational Society? no 
Is your School supported wholly by local School Board?* 
Is your School supported in part by local School Board?*
Is your School supported wholly by Freedmen? [[?]] of children 
Is your School supported in part by Freedmen?  Have you had Bureau transportation this term? no
Who owns the School-building? School Teacher
Is rent paid by Freedmen's Bureau?
What number of Teachers and Assistants in your School?
Total enrollment for the month?+ 28
Number enroled last report?
Number left school this month?
Number new Scholars this month? 4
What is the average attendance? all
Number of Pupils for whome tuition is paid? all
Number of White Pupils? None
Number always present? all
Number always punctual? all
Number over 16 years of age? 1
Number in Alphabet? none
Number who spell, and read easy lessons? 2
Number in advanced readers? 19
Number in Geography? 6
Number in Arithmetic? 17
Number in higher branches? 1
Number in Writing? all
Number in Needle-work?
Number free before the war?
Have you a Sabbath-School?
Have you an Industrial School?
State the kind of work done?

[[second column]]
Location (town, county, or district)? 
Of what grade?
When to close? Oct 18th, 1869 will continue night long
What Society?
Name of Board or Com.? Am't pd. this month?
Name of Board or Com.? Am't pd. this month?
Amount paid this month? $10.50
Amount paid this month?
How much per month? no
White? 1 Colored? 
Male? 10 Female? 11
{Number enrolled last report, by adding new scholars and subtracting those left school, must equal the present total enrolment.}
{Schools are to be kept five days per week and six hours each day.}
How many hours have you taught per day? About 6 hours every day
How many days have you taught this month?
Give reasons for deficiency of time, (if any,) in teaching.
How many Teacher? How many Pupils? 
How many Teachers? How Many Pupils?
To the following questions give exact or approximate answers, prefixing to the latter the word "about."
1. Do you know of any Schools for Refugees or Freedmen not reported to the State Superintendent? How many?
2. Give (estimated) whole number of pupils in all such Schools? No. of Teacher, White, Colored,
3. Do you know of Sabbath Schools not reported to the State Superintendent? How many?
4.Give (estimated) whole number of pupils in all such Schools? No. of Teacher, White, Colored,
5. State the public sentiment towards Colored Schools, nothing nothing that I know of.
6. How many pupils in your School are members of a Temperance Society? Name of the Society?
Remarks:
(Signed) Mrs. C. Coleman
Teacher
*Or School Committee, either District, Town, City, County, or State?
+ A pupil is not to be REPORTED as enrolled until after five days' attendance

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