PSR Registration

Family Information
Child's Name*
First Middle Last
Gender*
Date 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?
Where Grade
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 State
Confirmation Date
MM slash DD slash YYYY
Confirmation Church
Confirmation Address
City State
First Communion Date
MM slash DD slash YYYY
Communion Church
Communion Address
City State
Information and Fees
PSR 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.

Where	Grade

Family Information