Make your own free website on
The Pocatello Free Clinic
Student Volunteer Registration Form
429 Washington Avenue
Pocatello, ID 83201
Phone Number


Volunteer Details

How did you find us?

Please specify, if not in list.

Did you find the information you were looking for? -- Yes |No
Specific information not found :

How would you like to be contacted:

How often would you like to volunteer at the clinic?
Very Frequently |Occassionally |Rarely

Why do you want to volunteer at the Clinic?

What do you think about our website? Other Comments? :