Perry CEO - New Investor Form
Perry County CEO Board Members will use this form to submit information about Investors in the Perry CEO Program. This form will be used to create the invoice and tracking information by SICF for the Financial Reports.
Investor Contact Name
Levels of Support (Check all that apply)
Investor ($1,000 per year for at least 3 years)
Supporter (Other amount annualy for at least 3 years)
Base Site (Class meets at business for 9 weeks)
Mentor (Mentor 1 student per school year)
Confirm Dollar amount to be billed:
Date first invoice should be sent
Confirm the school years of support: (check all that apply)
2019 - 2020 School year
2020 - 2021 School year
2021 - 2022 School year
2022 - 2023 School year
2023 - 2024 School year
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This form was created inside of Southern Illinois Community Foundation.