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Hours of Operation
Tuesday 5-8pm
Thursday 5-8pm
Mailing Location:
Lake Area Free Clinic
856B Armour Road
Oconomowoc, WI 53066
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LAFC Volunteer Application
Volunteer Form
Thank you for your interest in volunteering with the Lake Area Free Clinic! Please fill out the form below and we will get in touch with you shortly. Please note, current patients of the Free Clinic are not eligible to volunteer due to privacy guidelines.
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*
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Last
Phone
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Address
Street Address
Address Line 2
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Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Birthday (Month, Day):
What is your desired volunteer role (please check all that apply):
Greeter
Screener
Interpreter (Spanish)
Nurse (LPN, RN)
Provider (Physicia, PA, RN)
Lab Tech
Pharmacist
Data Entry
Fundraising & Event Planning
Grant Writting
Computer Programming & Web Maintenance
Other
Do you have a current license in the state of WI for (check all that apply):
Physician
Registered Nurse
Licensed Practical Nurse
Physician's Assitant
Pharmacist
Dentist
Other
Please list any additional languages that you speak:
Please describe any other special skills and/or work experience you have:
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