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[Ed. Form, No. 3.]
TEACHER'S MONTHLY SCHOOL REPORT
For the Month of April, 1869.
District or County, Dorchester Co
State, Maryland
Name of School, Beverly School
Name of Teacher, Mary S. Osbourne

Forwarded  May 3rd 1869
Received  ~ 5th ~

EXPLANATIONS.
    If any of the within questions cannot be answered by the teacher, they may be left for the Superintendent. Place each answer, to the extent of your knowledge, opposite the question, and he will fill the remaining spaces. 
    Night and Sabbath schools taught by a group of teachers should be reported but once.  
    In the "Remarks" notice any important fact which the blank does not call for. 
    It is hoped that the Educational Societies will adopt this form of Report; if so, the Bureau can furnish the blanks.
    Should more extended forms be used, it would oblige the Commissioner to have them include all the items of this.
BUREAU R., F., AND A.L., Washington, D.C., October 1, 1868.