Home Study PSR Registration Form

Registration for New students and returning students
St. John Vianney Parish School of Religion (Gr. 1-8)
Complete this form include each child to be registered.
An asterisk * indicates required information.
When the box turns red it is incorrectly entered
fix the entry before you continue.
Click ‘I am not a robot, complete the task
after the green check appears click Submit.

Home Study: $35 per child

Fill in the following Information for each student your are registering doe Home Study PSR.- Complete Baptism Info for New Students Only - Please mail or drop off a COPY of the Baptism Certificate for each New Student.

Student 1 (Grades 1 - 8)

First Name, Middle Name, Last Name
NEW STUDENTS ONLY
NEW STUDENTS ONLY
NEW STUDENTS ONLY
i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc.

Student 2 (Grades 1 - 8)

First Name, Middle Name, Last Name
NEW STUDENTS ONLY
NEW STUDENTS ONLY
NEW STUDENTS ONLY
i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc.

Student 3 (Grades 1 - 8)

First Name, Middle Name, Last Name
NEW STUDENTS ONLY
NEW STUDENTS ONLY
NEW STUDENTS ONLY
i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc.

Student 4 (Grades 1 - 8)

First Name, Middle Name, Last Name
NEW STUDENTS ONLY
NEW STUDENTS ONLY
NEW STUDENTS ONLY
i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc.

Student 5 (Grades 1 - 8)

First Name, Middle Name, Last Name
NEW STUDENTS ONLY
NEW STUDENTS ONLY
NEW STUDENTS ONLY
i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc.

Family Information

Address, Street, City and Zip
Best Phone number to reach mother
Mother
Best Phone number to reach father
Father
Are you a registered member of St. John Vianney: *

We use the information provided above for our communications and records. In situations with blended families, grandparents providing PSR, and other circumstances, it is important for us to know who is involved and who needs information so that we can keep everyone well informed. Note that we can only send information to one additional address, but we can email/call others as needed.

Are there any other adults involved this year?
Are there any other adults PSR info should be sent to?

List Other Adults Involved in your children’s PSR

Involved in PSR
Send Info
Address, Street, City and Zip
Involved in PSR
Send Info
Address, Street, City and Zip

To submit this form: Check - I’m not a robot and complete the task. A green check will appear when completed correctly. Next click Submit. Wait to see the message that your responses will be sent to the SJV Faith Formation Office.

After you successfully SUBMIT your online registration form you may pay the PSR Home Study Fees for child/children registered. Pay by cash or check or make Payment Online now by clicking the Donate button below. You will be taken to PayPal where you can make payment.

Home Study: $35 per child

Total Due is $35.00 x number of Home Study PSR Students.