•  OFFICE: (607) 330-1253
  •  CLINIC: (607) 330-1254

Become a Volunteer

Fill Out The Form Below

Application Form

Please fill out this application form to be considered.
First Name

Last Name

Email

Preferred method of contact  Phone Email
Position



Do you speak another language?     yes no
If Yes, what language(s)?

Do you have a projected end date for volunteering with us?


Briefly state your reasons that you want to volunteer at the Ithaca Free Clinic?

Provide a brief list of your experience: