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[ED. FORM, NO. 4.]

TEACHERS MONTHLY 
SCHOOL REPORT.

For the month of  November 1867.  
District or County,  Northampton  
State,  Virginia  
Name of School, Lincoln School 
Name of Teacher, Misses Pellin & Darcy

Forwarded  
Received Nov 28" 1867 

EXPLANATIONS.
The accompanying Blanks is a copy of the Bureau Superintendent's Blank placed in columnar form for the sake of simplicity and to reserve entire uniformity.
It is hoped that the Educational Associations will adopt this blank, or one which will contain these questions.  (Should this exact form be adopted the Bureau can furnish the blanks).
If any question cannot be answered by the teacher, it may be left for their Superintendent.  Place each answer, to the extent of your knowledge, opposite the question and he will fill the remaining spaces.
It is supposed that no teacher has more than one day and one night school, or but one of either.
Night and Sabbath schools taught by a group of teachers should be reported but once.
The question, "when opened?" has reference to the present season.
The above explanations are deemed necessary where this blank is adopted by the Associations.
Should more extended forms be used, it would oblige the Commissioner to have them include all the items of this. 
Bureau R.F. & A.L., Washington. D.C., Oct. 1, 1866.