PSR Registration

Family Information
Child's Name*
First Middle Last
Gender*
Date of Birth*
Date Format: 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
Date Format: MM slash DD slash YYYY
Baptism Church
Baptism Address
City State
Confirmation Date
Date Format: MM slash DD slash YYYY
Confirmation Church
Confirmation Address
City State
First Communion Date
Date Format: 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