LIBERTY HIGH SCHOOL                                                                             LIBERTY HIGH SCHOOL

Name of Acct:  ________________________   Received by: _______________                              Name of Acct:  _________________________   Received by: ________________

Date: ________________________                                                                                             Date:  ___________________________

    Currency Count:                                                                                                                                           Currency Count: 

                ___________      x              $   1.00   =              $_______________                                                           __________         x              $   1.00        =              $_______________

                ___________      x              $   5.00   =              $_______________                                                           __________         x              $   5.00        =              $_______________

                ___________      x              $ 10.00  =              $_______________                                                           __________         x              $ 10.00      =              $_______________

                ___________      x              $ 20.00  =              $_______________                                                           __________         x              $ 20.00      =              $_______________

                ___________      x              ______  =              $_______________                                                           __________         x    ______              =              $_______________

                                                                Checks  =              $_______________                                                                                               Checks              =              $_______________

    Coin Count:                                                                                                                                                    Coin Count:

                ___________      x              $ 0.01     =              $_______________                                                           ___________      x              $ 0.01        =              $_______________

                ___________      x              $ 0.05     =              $_______________                                                           ___________      x              $ 0.05        =              $_______________

                ___________      x              $ 0.10     =              $_______________                                                           ___________      x              $ 0.10        =              $_______________

                ___________      x              $ 0.25     =              $_______________                                                           ___________      x              $ 0.25        =              $_______________

                ___________      x              $ 0.50     =              $_______________                                                           ___________      x              $ 0.50        =              $_______________

                ___________      x              $ 1.00     =              $_______________                                                           ___________      x              $ 1.00        =              $_______________

                                                Sub Total              =              $_______________                                                                                           Sub Total    =          $_______________

                                Beginning Change Fund                   $_______________                                                                           Beginning Change Fund                      $_______________

                                                                TOTAL  =              $________________                                                                                            TOTAL              =              $_______________

Type of Activity: ________________________________________________                   Type of Activity: ______________________________________________________

                                                (Dance, Candy Sales, Etc.)                                                                                                               (Dance, Candy Sales, Etc.)