Child Care Reimbursement Form - COVID-19 (HR)
Mar 20, 2023
submission
#309
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Employee Information
| Employee Name | --- |
| Employee number (4 digits, same as on your timesheet) | --- |
| Email (for questions) | --- |
| Phone number (for questions) | --- |
| Department name | Community Services Department |
| Division name | Recreation Services Division |
| Employee's Direct Supervisor (could be a Supervisor, Manager, or Director) | --- |
| Today's date | --- |
Child Care Receipts
| Date on which child care was provided - 1 | --- |
| Reimbursement request (up to $50) - 1 | --- |
| Receipt - 1 | --- |
| Comments / Description | --- |