Weekly Childcare Form

Your Information

Your Name

Your Phone Number

Your Email

This address will receive a confirmation email

Your Groups' Information

Group:

Date group occurred:

Worker #1 Name:

Worker #1 Hours:

0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #2 Name:

Worker #2 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #3 Name:

Worker #3 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #4 Name:

Worker #4 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #5 Name:

Worker #5 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #6 Name:

Worker #6 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #7 Name:

Worker #7 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #8 Name:

Worker #8 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #9 Name:

Worker #9 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #10 Name:

Worker #10 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #11 Name:

Worker #11 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #12 Name:

Worker #12 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #13 Name:

Worker #13 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #14 Name:

Worker #14 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #15 Name:

Worker #15 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Worker #16 Name:

Worker #16 Hours: 0.5hr 0.75hr 1hr 1.5hr 2hr 2.5hr 3hr Volunteer

Description

Weekly Childcare
The Facilitator/Group Leader of each group is required to fill out a Weekly Childcare Form that reports the childcare worker’s name, and how many hours childcare was provided. The Weekly Childcare Form will be received by staff members of Central, who then will arrange payment.

Payment
Childcare workers will be paid $15per hour and a maximum of 2 hours per week, per group. They will receive payment once a month, with the pay period consisting of the 1st-end date of each month. Checks will be written and mailed to the childcare workers within one week of the end of the pay period.

Weekly Childcare Form

Description

Please Fix the Following