•  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


Preferred method of contact  Phone Email

*note* not all positions available at all times, Administrative Volunteers on HOLD until April 2018

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

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

Why do you want to volunteer at the Ithaca Free Clinic?

Provide a brief list of your experience: