Radius Childcare Reimbursement Form

Radius will reimburse for childcare: $13 an hour for up to 3 hours for 1 or 2 children and $15 an hour for up to 3 hours for 3 plus children.

Name *
Name
Should not exceed $13 an hour for up to 3 hours for 1 or 2 children or $15 an hour for up to 3 hours for 3 plus children.
$
Mailing Address *
Mailing Address
If the email address you entered is not recognized by your bank, if your bank rejects the payment or your bank does not accept payment via Zelle, we will mail you a check. Don't forget to fill in the country. Sorry. It's the form.