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[Ed. Form, No. 3.]

Teacher’s Monthly 
School Report
For the month of  December 30th, 1869.
District or County, Prince george Co
State, Virginia Virginia
Name of School, Blackwater
Name of Teacher, Sarah Glover

Forwarded December 30th 1869
Received December 30th 1869

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.