Parish School of Religion

Student's Name (First, Middle, Last) REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

School Student Attends REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field. Please enter valid data.

Father's Name (First, Last) REQUIRED Please fill out this field. Please enter valid data.

Father's Phone Number REQUIRED Please fill out this field. Please enter valid data.

Mother's Name (First, Last) REQUIRED Please fill out this field. Please enter valid data.

Mother's Phone Number REQUIRED Please fill out this field. Please enter valid data.

Legal Guardian's Name: (First, Last) Please enter valid data.

Legal Guardian's Phone Number Please enter valid data.

Who does student live with: REQUIRED Both Parents Mother Father Shared Custody Legal Guardian Please fill out this field.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Parent or Guardian's Email REQUIRED Please fill out this field. Please enter an email address.

Class Type Desired REQUIRED Please fill out this field.

Phone Please enter valid data.

Emergency Contact (Other than Parents) Please enter valid data.

Emergency Contact Phone Number Please enter valid data.

Who may pick your child up from PSR class? Please enter valid data.

Special Needs? Yes No

If yes, explain:

Sacraments Received: Baptism Reconciliation (Confession) 1st Communion Confirmation

Date and Church each Sacrament was received

A copy of the student's Baptismal Certificate must be submitted on the first day of class (if not previously done).

After submitting the registration form, you will receive an email with instructions on how to make your payment online. Thank you!

St. Anthony of Padua Parish
New Orleans, Louisiana