Name of dependent:  |
Age:
|
|
Cost
|
Care for dependents and children under age 6:
Cost per week $ x
50 work weeks (or)
Cost per month $ x
11.5 months |
|
Care for children entering school next fall:
Full-time care until June: $ x
22 weeks
|
|
| Registration or activity fee
for summer care |
|
| Summer care: $ x
10 weeks |
|
| Registration cost for autumn
care |
|
Autumn before- and after-school
care:
$ x
16 weeks |
|
| Care during winter break: $ x
2 weeks |
|
Care for children who are currently full-day students:
Before- and after-school care: $ x
37 weeks |
|
| Full-time care for spring break:
$ x
1 week |
|
| Registration for summer care |
|
| Summer care: $ x
10 weeks |
|
| Full-time care for winter break:
$ x
2 weeks |
|
Subtotal expenses:
|
|
| Dependent 1: |
|
| Dependent 2: |
|
| Dependent 3: |
|
| Dependent 4: |
|
Total work-related dependent care expenses:
|
|
