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[Ed. Form. No. 4.]
Teacher's Monthly School Report. 
For the Month of Nov 30th 1866

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, and Name of School ... Home Colony
When Opened...
Societies, &c., Patrons ... Bureau
[[seal]]The National Archives of the United States[[/seal]]
Number of Schools sustained by freedmen ... 0
Number of Schools sustained in part by freedmen ... 0
Number of teachers transported by Bureau ...0
Number of School buildings owned by freedmen ... 0
Number of School buildings furnished by Bureau ... 1
Whole number of teachers ... 1 ...White - ... Colored 1
Whole number of pupils enrolled ... 46 ...Male 19... Female 27
Number of pupils enrolled last report ... -
Number left school this month ... 0
Number of new scholars this month ... 
Average attendance ... 40
Number of pupils paying tuition ... 0
Number of White pupils... 0
Number always present... 36
Number always punctual... 30
Number over 16 years of age ... 3
Number in Alphabet ... 0
Number who spell and read easy lessons ... 30
Number of advanced readers...16
Number in geography ... 0
Number in arithmetic ... 12
Number in higher branches ... 0
Number in writing...0
Number on needlework .. 0
Number free before the war ... 0
Number of Sabbath Schools ... 1
Number of pupils in Sabbath Schools ... 50

To these questions give exact, or approximate answers.

1. How many of above Schools are graded? 1 How many grades? 1
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? 1 White, 0 Colored, 1
4. How many Sabbath-Schools, within your knowledge, and not reported above? 0 Number of pupils ( estimated)in such Schools? -
5. How many Teachers in the above Sabbath-Schools? - White, - Colored, -
6. How many Industrial Schools? - Whole number of pupils in all? - State the kind of work done, -
7. Whole amount of tuition paid by Freedmen during the month, -
8. Whole amount of cost of transportation furnished by the Bureau for the month, -
9. Grand total of expense per month for support of above schools by all parties, 20
10. Whole number of High or Normal Schools, - How many pupils in all? -
11. Remarks

Edward Moore

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