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Program Forms and Materials

Program Guidelines

The UA Childcare Choice–Employee Program Guidelines identify:

  • The purpose of the program
  • Qualifying, work-related childcare expenses occurring in Arizona
  • How employees eligible for full benefits may receive such reimbursements


Enrollment Verification Form

The Enrollment Verification Form identifies a child’s enrollment with a childcare provider. Completed by the provider, this form is submitted by the employee as part of the E-Application process, and is also used when there are:

  • Multiple childcare providers
  • Provider changes

Submit a separate form for each provider. Email additional Enrollment Verification Forms to CCEmployee@email.arizona.edu as applicable. 


Cost Form

The Cost Form verifies an enrolled employee’s childcare payment over a specific period.

  • Complete and submit this form for applicable program reimbursement
  • Follow submittal deadlines by referencing the employee reimbursement calendar below


Reimbursement Calendar

The Reimbursement Calendar identifies monthly and quarterly Cost Form submittal deadlines and applicable pay periods for reimbursement.

Such forms may be submitted as frequently as every two weeks, but must be submitted at least once a quarter. Retroactive reimbursements from earlier quarters are not allowed.


Qualifying reimbursement submittals and reimbursement payments must occur during active employment with the University and in the corresponding July 1–June 30 fiscal year. There are no exceptions.