Connect Group Childcare Reimbursement
Thank You, we have received your form.
  • All forms must be submitted on a monthly basis by no later than the 15th of the following month. This should not include any future dates. Any forms turned in more than 1 month past the last meeting date will be declined. Please allow up to 2 weeks to receive your reimbursement.

  • Connect Group Leader's Name

  • Submitting Reimbursement Requests for the Month of

  • Childcare Worker Ratio & Reimbursement Rates:

    • 1 to 3 kids- 1 worker at $30 per session.

    • 3-8 kids- 2 workers at $60 per session.

    • 9+ kids- 3 workers at $90 per session.

    • 3 workers is the maximum that Centerpoint will reimburse for a Connect Group gathering.

  • Total Reimbursement Due

    Please use the information above to calculate this dollar amount.

  • Amount Paid

  • Amount Paid

  • Amount Paid

  • Amount Paid

  • Amount Paid

  • Preferred Reimbursement Method (mailed check/direct deposit)

    If you select direct deposit, our Finance Manager will contact you about filling out a direct deposit form.