2018-2019 PSR Registration Form
Welcome to the St. Francis of Assisi PSR program!
EACH CHILD WILL NEED TO BE REGISTERED SEPARATELY. Thank you.

For more information contact
Joan Hampton, SFA Director of PSR Program
jhampton@stfranciswichita.com
316-722-4404 - office
316-640-3368 - cell

Email address *
Is your family new to the PSR program? *
Registered at SFA? *
Our PSR is reserved for SFA registered members only. Please contact the parish office to register. (722-4404)
STUDENT INFORMATION
Student First Name *
Your answer
Student Last Name *
Your answer
Gender *
Grade for 2018-2019 *
Which school does your child attend? *
Your answer
At what parish was your child baptized? *
(If your has not been baptized, please contact the church office (722-4404)to sign up for RCIC classes)
Your answer
Has your child received First Holy Communion? *
Other Information: Special Needs, allergies, medical concerns, special requests
Your answer
PARENT INFORMATION
Parent First Name *
Your answer
Parent Last Name *
Your answer
Spouse Name
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
ex: (316-722-4404)
Your answer
Email Address *
Email is primary means of communication
Your answer
Secondary Email Address
Your answer
Emergency Contact Name *
Other than primary parent
Your answer
Emergency Contact Number *
Other than primary parent
Your answer
Permission to publish *
ex: The Catholic Advance, Vernacular, SFA webpage, PSR emails
Submit
Never submit passwords through Google Forms.
This form was created inside of St. Francis of Assisi Catholic School. Report Abuse - Terms of Service - Additional Terms