Board Members:

Shearry Kridelbaugh, Chair

John Chamness, Vice Chair

Mary Chappius, Treasurer

Judy Lueders, Secretary

Jane Myers

Joan Robinson

Mike Bohnert

Child/Youth Referral

Please provide the following information about the person you want to refer (remember all youth must be Perry County residents):  

Child's Name                                                                                
Parent's Name                                                                               
Address                                                                                           
Home Phone Number                                                                    
Work Phone Number                                                                     
Referring Program:  CHAMPS Mentoring
                                   Out-Of-School
                                   Seeking Answers
                                   SAAS (Seeking Answers About Substances)
                                   YAP (Youth And Parents)
 

 If you are referring your own child to the CHAMPS Mentoring Program, please print and complete the following forms:  

Letter of Permission
Checklist of Needs
Interest Inventory
 
and mail them to:            Perry County Community Task Force
                                                        406 N. Spring, Suite 4
                                                        Perryville, MO  63775
 
or email them to:                                pcctf@yahoo.com