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[Ed. Form, No. 3]
TEACHER'S MONTHLY 
SCHOOL REPORT

For the month of May 26 1869, 186_.
District or County, Hannacca
State, of virginia
Name of School, Quiocison
Name of Teacher, Rebecca vandervall

Forwarded 
Received 

EXPLANATIONS.
If any of the within questions cannot be answered by the teacher, they may be left for the Superintendent. Place each answer, to the extent of your knowledge, opposite the question, and he will fill the remaining spaces. 
Night and Sabbath schools taught by a group of teachers should be reported but once.
In the "Remarks" notice any important fact which the blank does not call for.
It is hoped that the educational societies will adopt this form of Report; if so, the Bureau can furnish the blanks.
☞ 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., Jan. 1, 1868.

Transcription Notes:
The county is spelled as written. The name of the school is as written. also looked at Page 42 where the school name is given.