Divine Word Parish School of Religion (PSR)
Registration Fees for 2023-2024 are $75.00 (one child), $130.00 (two children), $170.00 (three children) and $190.00 (four or more children).
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Email *
Registering Students Full Name: *
Gender: *
Date of Birth (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Parents Names: (First & Last) *
Street Address: (please include city, state & zip) *
Primary Phone: *
Father's Cell Phone: *
Mother's Cell Phone: *
Preferred email  for Communication: Parents Primary E-Mail:
Please put a semi colon  between more than one email.
 *
Did your child attend Divine Word's PSR program last year? *
What school does your child attend? *
Has your child been baptized? *New students please provide a copy of your Sacramental Certificates* *
Has your child received First Communion? *New students please provide a copy of your Sacramental Certificates* *
Has your child received Confirmation? *New students please provide a copy of your Sacramental Certificates* *
Choice of Day for PSR: *
If choice of day was Sunday, 9:30 AM - 10:45 AM: Please select which grade:
Clear selection
If choice of day was Wednesday, 4:30 PM - 5:45 PM: Please select which grade:
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If choice of day was Tuesday, 6:00PM - 7:15 PM, please select which grade: *
We understand that permission is required for our child's photograph to be published in the Divine Word Parish Bulletin, monitors, app, publicity brochures or Divine Word website. This permission is given for the duration of our child's education in Divine Word's PSR programs. *
Please indicate any special needs (allergies, etc.) your child may have. If there are none, please type "NONE." *
Are you willing to consider any volunteer opportunities? (please prayerfully consider) *
Registration Fees 23-24 (one child, $75, two children $130, three children $170 or four or more children $190). Please select which payment option you will complete below: *
A copy of your responses will be emailed to the address you provided.
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