Elizabethtown Child Care Center

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Thank you for your interest in having your child (ren) attend the Elizabethtown Child Care Center (ECCC).  Please complete and submit the form to the right.  A staff person will get back to you to discuss placement if there is an available spot or to place your child(ren) on our waiting list.

Completing an application does not guarantee placement at ECCC.  A staff member will contact you via email to confirm receipt of this application.


Date of Application
Parent/Guardian's Name (First & Last)
Address (Street, City, State, Zip)
Daytime Phone() -
Evening Phone() -
E-mail Address
Do you already have a child(ren) attending ECCC? (Type yes or no and the name(s)
Name & Birthdate of Children who need placement
Do you need full time care? Please list hours needed.
Do you need part time care? Please list days and hours needed.
When do you need care to start?
Any other information
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