Peer to Peer - Mentor Application
Have you been impacted by cystic fibrosis and are interested in becoming a resource for others impacted by CF? Are you interested in sharing your experiences related to CF and connecting with a mentee that could benefit from your guidance to help manage day-to-day life and challenges associated with CF?

If so, please complete this application in full and provide the requested documents. We are excited to match you to a mentee that will receive your support!


INSTRUCTIONS TO APPLY:
*Applicants are required to provide all of the following documents:

1.   Application
          -  Fill out in full.

2.    Video Submission
       -  In good lighting and a quiet area, take a brief selfie-style video (landscape format)
       -  Say your name, that you have cystic fibrosis (or your relation to who with CF), and what being a mentor means to you
       -  Emailed P2P@pipersangels.org with applicants name in subject line

**For individuals with privacy concerns please email us if you are not comfortable submitting your video. We respect your needs and boundaries and this will not hinder you from receiving the grant/program participation.

3.  One (1) Photo of what the reality of CF looks like for you: These photos/videos serve the purpose of inspiring more people to donate to the Piper’s Angels Foundation programs to help more CF families in need

       -  MUST be JPG or PNG files.  NO PDFs

       -  Must be original raw photos.  Cannot have filters, be edited, or be a screenshot.

       -  1 photo of what the reality of cystic fibrosis looks like for you

       -  Email to p2p@pipersangels.org  with applicants name in subject line

**For individuals with privacy concerns please email us if you are not comfortable submitting your photo. We respect your needs and boundaries and this will not hinder you from receiving the grant/program participation.

3. Photo Release Form
        - Must download and SIGN  "PAF Photo Release Waiver" from website.
        - Email back to P2P@pipersangels.org.  
        - Please include mentor's name in the subject line.

4.  Release of Liability Waiver
       - Must download and SIGN  "Release of Liability Waiver" from website.
       - Email back to P2P@pipersangels.org.  
       - Please include mentor's name in the subject line.

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Email *
First & Last Name *
What gender do you identify as: *
Which best describes your relation to CF? *
Cell Phone Number *
Date of Birth *
MM
/
DD
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YYYY
Street Address: *
City: *
State: *
Zip Code: *
Referred by: *
If 'Other' Referral please enter here:
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