PARISH SCHOOL OF RELIGION REGISTRATION 2008-2009

PRINT FORM AND MAIL TO: St. Elizabeth Ann Seton PSR, 2200 W. Republic Rd., Springfield, Mo  65807
Questions Contact: Debbie Randell, 887-6472, ext 210
Please enclose your payment unless you are in need of financial help.

FAMILY INFORMATION:

FAMILY Last Name:________________________________________________________

Address_____________________________________________________City_________________Zip_____

Phone____________________________________________ 

PRENT INFORMATION:

FATHER Name___________________________________________

Address_____________________________________City_______________Zip_____________

Phone Home___________________________Work_____________________Cell___________________

Marital Status ____________________________

Religion ________________________________

MOTHER Name________________________________________________

Address___________________________________________City__________________Zip_____________

Phone Home_________________________________Work___________________________Cell________________

Marital Status_________________________

Religion_________________________

STUDENT INFORMATION

Name First___________________________________ Last_________________________________

Grade in Sept. ____________ School_______________________    Sex   M  F     Date of Birth ___________

Health Problems _________________________________________________________________________________

MARK AN X FOR SACRAMENTS RECEIVED

Baptism__    First Reconciliation __      First Communion  __      Confirmation  __  

Where was your child Baptized?  Parish____________________________City____________________St. ________

If child was not Baptized at SEAS enclosed a copy of Baptismal record.

JR PSR (Must be 3 yrs old by August 1st)

3 Year Old:Sunday 9:00 __or 11:00 __ 4 Year Old Sunday 9:00 __ or 11:00__ Kindergarten Sunday 9:00__or 11:00 __

PSR 1ST - 8TH GRADE:        Grade ___   Sunday 10:30 - 11:30 __   or   Wednesday 6:30 - 7:30 __

FEES: $30.00 per child or Three or more $75.00. **Add $10.00 to your total for second grader making 1st Communion.     $40.00 for 1st Communion student.

MAKE CHECK PAYABLE TO: SEAS PSR   MAIL TO: SEAS PSR, 2200 W. Republic Rd., Springfield, Mo.  65807

I am in need of financial help ____

I would be willing to volunteer _______  One person my child would like to be with in class _________________________

Comments:______________________________________________________________________________________

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