Early Childhood Center Admission Application

GHC EARLY CHILDHOOD CENTER
515 Broadway Dobbs Ferry, NY 10522
914-693-4260 www.ghcny.org

APPLICATION OF ADMISSION
EARLY CHILDHOOD CENTER

(If your child already attends our ECC, please make sure you put YOUR name (not childs) on the above line and find your account so some or your information will prefill)

For all rates for our unique, boutique program, please contact our director at eccdirector@ghcny.org

SCHOOL YEAR: 2026-2027

APPLICANT INFORMATION

Child's Name

Last

Child's Name

First

Date of Birth:

Sex

Current address:

City

State

Zip Code

PARENT INFORMATION

Parent/Legal Guardian Name:

Last

Parent/Legal Guardian Name:

First

Occupation

Home Phone

Work Phone

Cell Phone:

Email:

Parent/Legal Guardian Name:

Last

Parent/Legal Guardian Name

First

Occupation:

Home Phone

Work Phone:

Cell Phone:

Email:

Family Synagogue Affiliation:

(If not applicable at this time, just state none)

Number of other children:

Name

Date of Birth

Name:

Date of Birth:

Name:

Date of Birth

PROGRAMS OF INTEREST

(Note: copy of Birth Certificate is REQUIRED for all programs listed)

Please select:Two-day 2 Year Old Program...............(2 by 12/31/26)...............Tuesday/ThursdayThree-day 2 Year Old Program.............(2 by 12/31/26)...............Monday/Wednesday/FridayFive-day 2 Year Old Program................(2 by 12/31/26)...............Monday - FridayThree-day 3 Year Old Program..............(3 by 12/31/26)...............Monday/Wednesday/FridayFive-Day 3 Year old Program.................(3 by 12/31/26)..............Monday - FridayFive-day 4 Year Old Program.................(4 by 12/31/26)..............Monday-Friday

EXTENDED DAY OPTIONS

12:00 - 2:00 pm

Specify above:
1-4 days per week = advise how many days and if you know the exact days, please advise or speak with ECC director (ex: 2-days Tues and Thursday)

5-days per year for full year

12:00 - 4:00 pm

Specify above:
1-4 days per week = advise how many days and if you know the exact days, please advise or speak with ECC director (ex: 2-days Tues and Thursday)

5-days per year for full year

12:00 - 6:00 pm

Specify above:
1-4 days per week = advise how many days and if you know the exact days, please advise or speak with ECC director (ex: 2-days Tues and Thursday)

5-days per year for full year

EARLY MORNING DROP OFF

Early Morning Drop Off

Early Morning Drop OffWe offer early morning drop off, 8-9am. If interested, please check this box

Please advise how you heard of GHC's early childhood program

If you were referred by a current member, please advise by whom. If you heard of us through advertising, word of mouth, browsing the internet etc., please be as specific as possible. Thank you!.

A non-refundable deposit of $500.00 MUST accompany this application. Payment will be applied toward the 2026-2027 tuition. If you wish to pay by credit card, please click HERE and you will be directed to our donation/payment page. Click on the donation drop down button and go to the appropriate ECC program you are enrolling in (example: ECC 2026-2027 Deposit 2's). Please note there is a small 3% fee when you pay by credit card. You can also send in a check to our office. Please mark it "Deposit for (name of child and the designated program) for 2026-2027 tuition.

PLEASE NOTE: GHC does not publish its tuition rates on its website. If you have not received a detailed list of our enrollment policies, including all class rates and if applicable, the special sibling discount we offer, please contact our Director of Education, Shaatrice Rossi, at eccdirector@ghcny.org.

E-signature of Parent or Guardian

Date:

Tue, January 20 2026 2 Sh'vat 5786

Greenburgh Hebrew Center
515 Broadway
Dobbs Ferry, NY 10522
(914) 693-4260

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