2020-2021 Community Partner App:
Thank you for your interest in becoming a Community Partner for Pacific Charter Institute and its family of schools: Heritage Peak Charter School, Rio Valley Charter School, Valley View Charter Prep, and Sutter Peak Charter Academy. Please complete all sections of this request form for consideration to become a PCI Community Partner.

NOTE: Please proofread your responses/answers as they will not be automatically corrected.
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Community Partner Information
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Service Information
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Additional Business Information
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Liability Insurance
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PCI Invoice Requirements & Active Vendor Protocols
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Agreement & Acknowledgement
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Community Partner Information
2
Service Information
3
Additional Business Information
4
Liability Insurance
5
PCI Invoice Requirements & Active Vendor Protocols
6
Agreement & Acknowledgement
  • Business Information

  • The Business Name will be used as the listing on the public listing of the Community Partner List upon application approval.
  • This will be listed on the public listing of the Community Partner List upon application approval.
  • This will be listed on the public listing of the Community Partner List upon application approval.
  • COUNTY the business is located. This will be listed on the Community Partner List upon application approval.
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    This will be listed on the Community Partner List upon application approval.
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    This will be listed on the Community Partner List upon application approval.
  • This will be listed on the Community Partner List upon application approval.
  • This will be listed on the Community Partner List upon application approval.
  • Click on Browse to locate and attach a copy of your Business License registered with your state. Failure to attach a copy of your Business License may result in a delay to the application process. Acceptable file formats include .jpg, .jpeg, .pdf, and .png.
  • Owner/Manager Information

    Complete this section if different from Business Information.
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  • Payment Information

  • Click on Browse to locate and attach a copy of your W-9. In order to issue payment on future invoice submissions should this application be approved, the W-9 must be filled out in its entirety. Failure to attach a completed W-9 may result in a delay to the application process. Acceptable file formats include .jpg, .jpeg, .pdf, and .png.
  • Pay to the order of must match the information provided on the W-9.
  • Address of where checks and correspondence will be mailed. Complete if different from Business Address.
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