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[Form No. 696.]
Of the County of...
office.
(See Regulation 17, page 85, 8cliool Lfl\\'j-)
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NAME.
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DIRECTIONS.—Write plainly. Do not write hetween the lines.
as the'case may be; before each name. - If a teacher’s post-office is in
Tn cities, write street and number of residence.
These forms should be filled up and returned to the Department of Public Instruction, ON OR BEFORE DECEMBER 20
GENSUS OF GOLORED TEAGHERS
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, for the School year closing July 31,
JOHN E. MASSEY, Superintende
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PEIIDIANENT POST-OFFICE.
Write only on this side of the paper. Write Mr., Mrs.,or Miss,
anothetr county, write name of such county on line with post-