UW-Washington County : Childcare Reimbursement

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Current Students
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To apply for childcare reimbursement through UW-Washington County's Student Government Association (SGA), you will need to:

Enroll for a minimum of six credits at UW-Washington County.
Complete this form. Note: Application period is limited to the first four weeks of the fall and spring semesters.
Submit a copy of your class schedule. (Drop off a copy of your schedule in the main office to the
attention of Debbie Butschlick or email a copy to her.)
Wait approximately seven business days for decision. When all information is received, you will be contacted regarding the committee's decision on your individual case. The rate of reimbursement is based on the number of accepted applicants and the amount of class hours per week each applicant has. The reimbursement amount will not exceed $2.00 per contact hour.

If you have questions with this form or need additional help, contact Debbie Butschlick.

First Name:
Last Name:
Address 1:
City:
State:
Zip Code:
E-Mail Address

Credits Registered for in current semester

No. of children for which you will claim

Ages of children for which you will claim:

Do you receive any other Federal or State money for school tuition or child care?

If yes, indicate name of program. If no, state "no additional funding received".
Type in name of program that you received federal or state funds through.

Childcare Provider Information

Name of Provider:
Director (if facility):
Street Address:
City:
State:
Phone:
Amount paid per week: $

Please provide a brief description of your daily routine to allow us to get a better idea of your need for this service.
Please describe your daily routine here

Note: Please press submit only once. Allow a minute or so for information to transfer.
To receive any funding, a copy of your CURRENT CLASS SCHEDULE must be submitted.
Email a copy to Deb Butschlick or drop off a copy in the main office (to her attention) or
in her office (located in far corner - within gymnasium).

More information on the Childcare Reimbursement Program

© 2003 University of Wisconsin-Washington County :: 400 University Drive, West Bend, WI 53095
Main Phone: 262-335-5200 :: Student Services: 262-335-5201
E-mail: wshwebmaster@uwc.edu