| |
Last
Year’s Expenses
|
This
Year’s Projected Expenses
|
Infant/Toddler
|
|
|
Preschool
|
|
|
| Before
& after school care |
|
|
School
half days
|
|
|
In-service
days (child not in school)
|
|
|
School
holidays
|
|
|
| School
vacation days |
|
|
Other
dependent care
|
|
|
| Total
expenses for the year |
|
|
| Divide
total by your number of regular pay periods |
| Enter
this amount into your Election Form. |
