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[Ed. Form, No. 3.]

TEACHER'S MONTHLY SCHOOL REPORT
For the month of November, 186 .
District or County, Dorchester Co. 
State, Maryland.
Name of School, Janifer Inst.
Name of Teacher, A.H. Levi

Forwarded Cyrus St Clair Trustee
Received 

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 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.