Broadway United Methodist Church :: Bowling Green, KY | Small GroupChildcare Reimbursement

Broadway United Methodist Church


	Search SUNDAY SERVICE TIMES Melrose Campus 8:15, 9:30, 11:00, 6:00 Greenwood Campus 9:00 AM First Time Guest Broadway UMC 1323 Melrose Street, Bowling Green, KY 42104(270) 843-3942 info@broadwayunited.org

Childcare Reimbursement Form

Authorization Number (required)

Name
(Reimbursement Payable to)

Address

Phone#

Secondary#

Please fill out ONE form for each small group meeting.

Small Group Meeting Date

Small Group Leader's Name

Name of Childcare Provider
Phone

# of Children # of Hours Amount
(See Reimbursement Chart Below)

Childcare Reimbursement Chart
Number of Children	Number of Hours
Number of Children	1	2	3
1	$7.00	$14.00	$21.00
2	$7.50	$15.00	$22.50
3	$8.00	$16.00	$24.00
4	$8.50	$17.00	$25.50
5	$9.00	$17.00	$27.00

Names of Children

Does this represent multiple families? yes no

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