Create Online Application

Complete this form to create an online application. The password must be 4-10 characters.
Please be sure to fill out all fields above the "For Office Use Only" section. Once done, hit the top "Submit" button.

* First Name

Middle Name

* Last Name

* Birthdate (mm/dd/yyyy)

* Email Address

* Confirm Email

Passwords expire every 365 days. Please follow all requirements when updating your password. Please email registrar@psr.edu if you have any questions.

* Password

* Confirm Password

*****************************FOR OFFICE USE ONLY****************************
PLEASE DO NOT USE THE FIELDS OR BUTTONS BELOW THIS LINE.

* ID

* Password

* Email Address