Divine Mercy PSR registration

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Please use this form to pick a PSR option for your family this year, register your children, and make your payment.

If you have any questions, or if you prefer to register by phone, please contact Theresa Conley at 419-399-2576

Family Last Name *

Primary Address *

Mother's name *

Mother's phone number *

Father's name *

Father's phone number *

Primary email address *

For PSR this year, our family is choosing *

Traditional homeschooling: working at home from the textbook

The "Family Catechesis" option

I need help figuring out what will be best for my family. Please contact me.

Do you give permission for your child's name and image to be included in publicity releases about parish events in the bulletin, parish website, social media, and/or the local newspapers? *

Yes

Which payment option would you like to use for this year? *

I would like to pay online at https://members.myeoffering.com/

I would like to pay by check

I would like to request financial aid

Child #1 Name *

Child #1 Grade in school *

Child #1 Allergies, medical conditions, or special learning needs? *

Child #2 Name

Child #2 Grade in school

Child #2 Allergies, medical conditions, or special learning needs?

Child #3 Name

Child #3 Grade in school

Child #3 Allergies, medical conditions, or special learning needs?

Child #4 Name

Child #4 Grade in school

Child #4 Allergies, medical conditions, or special learning needs?

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