Become a member

Some may find it helpful to preview the PDF application before submitting via the online form. If you would like to send us a written copy, please print and fill out the PDF version. This form should then be sent by mail along with the necessary documentation and annual member fee.

February 18th, 2022 is the first submission deadline to be apart of the first group of mini-grant and clinic-level dashboard disbursements.

All written submissions, documents, and checks can be sent to: Illinois Association of Free & Charitable Clinics
42 Stephen St. #416
Lemont, IL 60439

Clinic Operational BudgetAnnual Membership FeePotential Mini-Grant (Fee x3)