Calculator Test

STEP 1: Choose your Little Zak's Centre:

1. How many children do you have (or will have) in long day care?

2. What is the age of the child/children?

Child 1

3. How many days per week does each child attend (or planning to attend) long day care?
Child 1
Child 2
Child 3
Child 4
Child 5

4. What is your combined family income that you report to Centrelink, rounded to the nearest $5,000?

5. What are the hours of 'recognised activity' typically undertaken each fortnight by the parent who does the least?
0 - 7 hours8 - 16 hours17 - 48 hours49+ hours

6. What best describes your family?
[radio* family-description default:1 "Couple, both working full time" "Couple, one working, one not working" "Sole Parent, working full time" "Sole Parent, not working" "Couple, one working full time, one part time" "Couple, both not working" "Sole Parent, working part time" "Other"]

7. First Name

8. Last Name

9. Mobile

10. Email