Special Education Program Inquiry

Thank you for your interest in Green Chimneys' Special Education Program.

For more information about Green Chimneys School for your child or student, please complete the form below or contact Admissions at 845.279.2995 x115.

All information submitted within this form will be kept confidential.
We will respond as quickly as possible.

Parent's name
Email
Phone
Best time to call on weekdays between 9am-5pm?
Referring Professional (if any)
Child's age
School district
Grade level
Description of child's challenges
Referral contact information
Child's name
Do you have a specific question?
Describe any disability your child may have
How did you hear about our program?
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