Free Air Duct Cleaning Application
Thank you for your interest in receiving the complimentary air duct cleaning services provided by Stanley Steemer of South Florida & the Treasure Coast in partnership with Piper's Angels Foundation! If you are a CF family or know of a CF family in the South Florida area that may be interested in providing the best indoor air quality for their family, please fill out this application and submit the required documents.

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

1.   Application
       -  Fill out in full.
   
2.    CF Verification Letter from social worker or doctor
        - Your CF social worker or doctor needs to personally write a verification letter (on hospital letterhead)
confirming CF diagnosis.
        - Emailed directly to info@pipersangels.org from their work email.

3.    Photo Submission:  Send One (1) Photo of what the reality of CF looks like for you.  These photos serve the purpose of enlightening and educating people to the realities of life with CF and thus 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 info@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.  


4.   Photo/ Video Release Form
        - Must download and SIGN  "PAF Photo Release Waiver" from website.
        - Email Photo Release Form, your photos of home getting serviced and individual/ family photo at home                to  info@pipersangels.org 
        - Don't forget to include applicant's name in the subject line.

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First Name  *
Last Name  *
Date of Birth *
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Phone Number *
Street Address *
City *
State *
Zip Code *
How many people live in your home? *
CF Care Center Name *
CF Care Center City *
Who were you referred by? *
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