PSR Registration Form Registration for New students and returning students St. John Vianney Parish School of Religion (Gr. 1-8)Complete this form for each child to be registered.When the box turns red it is incorrectly entered fix the entry before you continue.Click Submit after completing each form. If you are human, leave this field blank. Childs Name * First Name and Last Name Fathers Name * First Name and Last Name Mothers Full Name (Include Maiden Name) * Mothers First Name, Last Name and Maiden Name Address * Street, City and Zip Phone Number * Best Phone number to reach parent Phone Number to reach a parent during PSR times * Email Address Child's Birthday * Birthplace * City and State Child Lives With: * Custodial Parent: Religion of Mother Relgion of Father Which PSR option are you registering for? Sunday PSR classes Home Study PSR Grade in 2017-18 * Public School Child Attends * Are you a registered member of St. John Vianney? * Yes No If No, which parish are you a member of? Special Circumstances: i.e. attention deficit, learning disabled, asthma, allergies, illnesses, etc. Sacraments Only needs to be filled out for new students Child's Church of Baptism Church and City/State Date of Baptism Child's Reconciliation (Penance) Church and City/State Date of Reconciliation Child's First Communion Church and City/State Date of First Communion Child's Confirmation Church and City/State Date of Confirmation Click Submit below When all information is complete. Click the Submit button below to send the form through to the PSR office. Please send a separate email to the PSR office at email@example.com indicate the names of the children you registered via this form.