Childcare Expense Request

Please use this form to request receipts for Childcare from ECC, Afterschool, Camps and Vacation Programs. It can take up to 2 weeks to process.

If you are looking for receipts for membership for fitness benefit, please go here: https://www.worcesterjcc.org/forms/health-reimbursement-letter-request/

Today's Date

Requestor First Name

Requestor Last Name

Childs Name

Confirm Email

Phone

Address

Address2

City

State

Zip

*Requests can take up to 2 weeks to process

Period Receipt Request For