PSR registration
Family Information
* Required
Email address
*
Your email
Are you new to PSR?
Choose
No
YES
PSR options
*
At home
Wait List for In Person
Last Name
*
Your answer
Mother's Name
*
Your answer
Father's Name
*
Your answer
Marital Status of Parents
Married
Separated
Divorced
Deceased
Remarried
Clear selection
Child (ren) live(s) with:
Both Parents
Mother
Father
Guardian
Clear selection
Email (best one)
*
Your answer
Has any information changed since last year? If so, tell us what- new address? email? phone #?
Your answer
Family Mailing address (if new)
Your answer
Primary Phone # (where you can be reached during PSR)
Your answer
Add'l email address:
Your answer
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