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[Ed. Form, No. 3.]

For the month of July, 1869.
District or County, Norfolk
State, of Virginia
Name of School,  Bethel
Name of Teacher, Samuel Luffman

Forwarded  August

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:
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