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[ED. FORM, NO. 4.]
TEACHER'S MONTHLY SCHOOL REPORT,
For the Month of  186 .

☞ 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.

[[stamp]] THE NATIONAL ARCHIVES OF THE UNITED STATES [[/stamp]]

Number of Day-Schools [[strikethrough]] 5 [[/strikethrough]] 1
Number of Night-Schools 0
Location, and Name of School R. S. F. G.
When opened
Societies, &c., Patrons
Number of Schools sustained by freedmen 0
Number of Schools sustained in part by freedmen
Number of teachers transported by the Bureau
Number of School buildings owned by freedmen 0
Number of School buildings furnished by Bureau 0
Whole number of teachers 1
White
Colored
Whole number of pupils enrolled 35
Male
Female
Number of pupils enrolled last report 
Number left school this month School discontinued July 26th
Number of new scholars this month 0
Average attendance 25
Number of pupils paying tuition 0
Number of White pupils 0
Number always present 
Number always punctual 0
Number over 16 years of age
Number in Alphabet 3
Number who spell and read easy lessons 1 2
Number of advanced readers 0
Number in geography 0
Number in arithmetic 0
Number in higher branches 0
Number in writing 0
Number on needlework 0
Number free before the war 0
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? 
How many grades?
2. How many Day or Night Schools, within your knowledge, not reported above?
Number of pupils (estimated) in such Schools?
3. How many Teachers in the above Day or Night Schools? 
White,
Colored,
4. How many Sabbath-Schools, within your knowledge, and not reported above?
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 expenses for the above Schools by the Bureau for the month,
9. Grand total of expense per month for support of above schools by all parties,
10. Whole number of High or Normal Schools,
How many pupils in all?
11. Remarks


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