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.

Required *

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.

Password

Email Address