2017-18 St. Francis PSR Registration Form
WELCOME to the St. Francis PSR program for K-8!
EACH CHILD WILL NEED TO BE REGISTERED SEPARATELY- THANK YOU!
For more information contact:
Kelly Brandt, SFA Director of PSR Program
stfranciswichitapsr@gmail.com (preferred)
316-641-1022
Is your family new to the SFA PSR program? *
Registered at SFA? *
Our PSR program is reserved for SFA registered members only. Please contact the parish office (722-4404) to register.
STUDENT INFORMATION
Student First Name *
Your answer
Student Last Name *
Your answer
Gender *
Grade for 2017-2018 *
Which school does your child attend? *
Your answer
Has your child been baptized? *
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 will be 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
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