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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.

[Answers placed here.]
Name of your School? Burrell School   
Location (town, county, or district)?  
Is it a Day or Night School?  Day school
Of what grade? Primary School
When did your present session commence? Nov 14th  
When to close? 
Is your School supported by an Educational Society?   
What Society? 
Is your School supported wholly by local School Board?* It is  
Name of Board or Com.?   
Am't pd. this month? 
Is your School supported in part by local School Board?*   
Name of Board or Com.?   
Am't pd. this month? 
Is your School supported wholly by Freedmen?  - 
Amount paid this month? 
Is your School supported in part by Freedmen?  - 
Amount paid this month? 
Have you had Bureau transportation this term? -
Who owns the School-building? American Missionary Association
Is rent paid by Freedmen's Bureau?   
How much per month? 
What number of Teachers and Assistants in your School? One  
White? 
Colored? 
Total enrolment for the month?†  Forty 
Male?  17
Female? 23
Number enrolled last report?   Twenty Seven

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

Number left school this month? 
Number new Scholars this month? Thirteen
What is the average attendance? Twenty Seven

{Schools are to be kept five days per week and six hours each day.}

How many hours have you taught per day? 6
How many days have you taught this month? 18
{Give reasons for deficiency of time, (if any,) in teaching.
Vacation for holidays
[[Stamp]]}

Number of Pupils for whom tuition is paid? Not any
Number of White Pupils? Not any
Number always present? 
Number always punctual? 
Number over 16 years of age? Four
Number in Alphabet? Not any
Number who spell, and read easy lessons? All
Number in advanced readers? 
Number in Geography? All
Number in Arithmetic? All
Number in higher branches? Not any
Number in Writing? All
Number in Needle-work? 
Number free before the war? 
Have you a Sabbath-School?   We have
How many Teachers?   
How many Pupils? 
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) [[S. C. Ostranter]]
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:
Does stamp have to be indicated as a stamp?