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[ED. FORM, No. 4.]
TEACHER'S MONTHLY SCHOOL REPORT,
For the Month of January 1867.

☞A School under the distinct control of one Teacher, or a Teacher with one assistant is to be reported as one School.
☞To be forwarded as soon as possible after the 1st of each month.

Number of Day-Schools 1
Number of Night-Schools 0
Location, or the Name of School 0
When opened 0
Societies, &c., Patrons 0
Number Schools sustained by freedmen 0
Number of Schools sustained in part by freedmen 0
Number of teachers transported by Bureau 0
Number School buildings owned by freedmen 0
Number of School buildings furnished by Bureau 0
Whole number of teachers 1
White 1
Colored 0
Whole number of pupils enrolled 5
Male 3
Female 2
Number of pupils enrolled last report 5
Number left school this month 0
Number of new scholars this month 0
Average attendance 5
Number of pupils paying tuition 0
Number of White pupils 5
Number always present 5
Number always punctual 5
Number over 16 years of age 0
Number in Alphabet 1
Number who spell and read easy lessons 2
Number of advanced readers 2
Number in geography 0
Number in arithmetic 4
Number in higher branches 0
Number in writing 0
Number on needlework 0
Number free before the war 5
Number of Sabbath Schools 0
Number of pupils in Sabbath Schools 0 

(To these questions give exact or approximate answers.)
1. How many of above Schools are graded? 0
How many grades? 0
2. How many Day or Night Schools, within your knowledge, not reported above? 0
Number of pupils (estimated) in such Schools? 0
3. How many Teachers in the above Day or Night Schools? 0
White, 0
Colored, 0
4. How many Sabbath-Schools, within your knowledge, and not reported above? 0
Number of pupils (estimated) in such Schools? 0
5. How many Teachers in the above Sabbath-Schools? 0
White, 0
Colored, 0
6. How many Industrial Schools? 0
Whole number of pupils in all? 0
State the kind of work done, 0
7. Whole amount of tuition paid by the Freedmen during the month, 0
8. Whole amount of cost of transportation furnished by the Bureau for the month, 0
9. Grand total of expense per month for support of above schools by all parties, 0
10. Whole number of High or Normal Schools, 0
How many pupils in all? 0
11. Remarks 0

S. S. Niekell

☞This Report is incomplete unless each blank is filled by a number, or cypher.