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[Ed. Form, No. 3.]

Teacher’s Monthly 
School Report
For the month of November [[strikethrough]] Dec 15 [[\strikethrough]], 1869,,
District or County, 5th District Washington Co
State, of Va.
Name of School, Free School
Name of Teacher, M J Taylor

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., October 1, 1868.

Transcription Notes:
---------- Reopened for Editing 2024-06-16 23:53:14 formatting issues Co may possibly be C8?