Peer to Peer Program - Mentee Application
Are you impacted by cystic fibrosis and interested in connecting with a mentor that will provide you with guidance and resources 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 mentor that will give you the one-on-one support that best fits your personal needs!


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

1.   Application
          -  Fill out in full.

2.   Photo Submission: 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 and the word PHOTO


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

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