Online Registration Form

You will be contacted via phone shortly regarding the status of your on-line request.

Child's Name:

Date of Birth:

Address:	Line 1 Line 2 Line 3


Parent's Name:

Phone #:

Which days of the week/hours are you interested in childcare for?


You will be contacted via phone shortly regarding the status of your online request.

Enter the code displayed in the box above:

Fred Sussman
Director of Kindercollege
Sarah Wells Building
115 South Street
Middletown, NY 10940
(845) 341-4165

Fax:
(845) 341-4433