PSR Registration Form Family InformationChild's Name* First Middle Last Gender*MaleFemaleThird ChoiceDate of Birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City ZIP Code Primary Phone*Alternate Phone*School Child Attends 2020/2021* Grade 2020/2021* Did your child attend PSR last year?* Yes No If YES, where and what grade?WhereGrade Father's Full Name First Middle Last Religion Mother's Full Name First Middle Last Religion Email* (We communicate primarily by email. Please provide an accurate email address and check it often.)Registered Members of Little Flower Parish?* Yes No If NO, where are you currently registered? Sacramental Information(Please attach a copy of the Baptismal Certificate if not baptized at Little Flower.)Baptism Date MM slash DD slash YYYY Baptism Church Baptism Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Confirmation Date MM slash DD slash YYYY Confirmation Church Confirmation Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State First Communion Date MM slash DD slash YYYY Communion Church Communion Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Information and FeesPSR Classes are held on Sunday mornings from 8:55 – 9:40 a.m. at Little Flower School. Fees are $75 for the first child; $65 for the second child; $60 for the third child. The first day of class for students will be on September 20th, with a remote parent informational conference call on Wednesday, September 16th at 6:30 P.M.
