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[Ed. Form, No. 3.]
TEACHER'S MONTHLY SCHOOL REPORT
For the Month of November, 1869.

☞ 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.

[Answers placed here.]
Name of your School?    
Location (town, county, or district)?  
Is it a Day or Night-School? day 
Of what grade? 
When did your present session commence? Nov. 69
When to close? 
Is your School supported by an Educational Society? no
What Society? 
Is your School supported wholly by local School Board?* no
Name of Board or Com.?   
Am't pd. this month? 
Is your School supported in part by local School Board?* no 
Name of Board or Com.?   
Am't pd. this month? 
Is your School supported wholly by Freedmen? yes
Amount paid this month? 
Is your School supported in part by Freedmen? no
Amount paid this month? 
Have you had Bureau transportation this term? no
Who owns the School-building? Freedmen
Is rent paid by Freedmen's Bureau? no 
How much per month? 
What number of Teachers and Assistants in your School? 1
White? 0
Colored? 1
Total enrolment for the month?† 20
Male?  9
Female? 11
Number enrolled last report? 0

{Number enrolled last report, by adding new scholars and subtracting those left school, must equal the present total enrolment.}

Number left school this month? 0
Number new Scholars this month? 20
What is the average attendance? 15

{Schools are to be kept five days per week and six hours each day.}
How many hours have you taught per day? 
How many days have you taught this month? 
{Give reasons for deficiency of time, (if any,) in teaching.}

Number of Pupils for whom tuition is paid? 20
Number of White Pupils? 0
Number always present? 15
Number always punctual? 15
Number over 16 years of age? 1
Number in Alphabet? 0
Number who spell, and read easy lessons? 12
Number in advanced readers? 8
Number in Geography? 10
Number in Arithmetic? 15
Number in higher branches? 0
Number in Writing? 12
Number in Needle-work? 0
Number free before the war? 0
Have you a Sabbath-School? 1
How many Teachers? 2
How many Pupils? 20
Have you an Industrial School?   
How many Teachers?   
How many Pupils? 
State the kind of work done? 

☞ 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 Teachers, 
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 Teachers, 
White, 
Colored, 
5. State the public sentiment towards Colored Schools, 
6. How many pupils in your School are members of a Temperance Society?   
Name of the Society? 
Remarks. 

(Signed) J.A. Thompson
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.

Transcription Notes:
not a table

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