Welcome to the State of California 

New Vendor Application

Thank you for your interest in becoming a WIC authorized vendor.  Effective 9-15-2014, the United States Department of Agriculture (USDA) has granted the CA WIC Program the authority to begin the second phase (Phase 2) to lift the California vendor moratorium.  Phase 2 allows Vendors that meet the Full Line Grocery Store (PDF) criteria to now apply for WIC authorization. 
Current vendors meeting Phase 1: Additional stores on Current WIC Vendor Agreement, may continue to apply for authorization for store locations.

If your store location meets the above criteria, follow the Instructions below to download the Vendor Application, forms, and informational materials.

Please e-mail the application and supporting materials as attachments to WICVENDORINFO@cdph.ca.gov and include the store address in the subject line of the e-mail. 

Minimum Requirements

  • Browser: Internet Explorer 9 (IE 9) or higher
  • Operating System: Windows 7 or earlier versions (Currently the application does not work with Windows 8)
  • PDF Reader: Adobe Reader (If you do not have Adobe Reader installed, you can get a free copy at the Adobe website: http://get.adobe.com/reader/)


Before beginning, please be sure you have Adobe Reader to open the file correctly.  If you do not have Adobe Reader, please download the free version provided in the link above. 

Step 1: Download and save the vendor application instructions (PDF) for reference while completing the Online Vendor Application..

Step 2: Once you click on the Vendor Application link (PDF) the Online Vendor Application will appear.  This is a PDF document and you must use Adobe Reader to open the document correctly.

Step 3: IMPORTANT! You MUST save the document as the store address and city (for example: "123 Main Street, Sacramento") to your desktop or file folder (‘File’, ‘Save As’) BEFORE entering any information!  Do not complete the form directly in your browser window as your data will not be saved.  Spaces and commas are allowable in the file name.  Note: The following special characters are NOT allowed in the file name: / \ : * ? “ < > |

Step 4: Close the browser window.  You must use Adobe Reader to open the Vendor Application file that was saved to your desktop.

Step 5: Once the Vendor Application is opened in Adobe Reader, complete the form according to the document instructions downloaded in Step 1.

Step 6: After completion of the Vendor Application, click ‘File’ > 'Save', 'File' > 'Save As' > 'Save', or the Save icon in the document.

Step 7: A pop-up message may let you know that you need to e-mail the completed application and required documents to WICVENDORINFO@cdph.ca.gov.  If you see that pop-up window, click OK.

Step 8: Print the certification (signature) page, sign and scan it.  Do NOT scan the entire application - only the signed certification page. 

Step 9: Open your e-mail application (for example: Yahoo, Gmail or Outlook) and create a new message/e-mail.

Step 10: In the new message/e-mail, be sure to attach the following required documents as specified in the application:

·         Completed Vendor Application form (PDF – all 7 pages) saved with your store address and city (this must be the electronic file saved in your computer – NOT SCANNED);

·         Scanned, signed certification page (Scan ONLY Page 7 of the Vendor Application);

·         Scanned copy of the signed and dated Vendor Agreement (PDF) (if you currently do NOT have an existing CA WIC Vendor Agreement)
OR scanned copy of the signed and dated Addendum (PDF) and scanned Exhibit A (PDF);

·         Any other attachments that are required (for example: health permit, seller’s permit, etc.)

Step 11: Send your new message/e-mail with attachments to WICVENDORINFO@cdph.ca.gov.

If you have any questions on completing this form please contact the WIC Vendor Management Branch at: (855) 942-7867
If you are experiencing technical difficulties, please contact the WIC Technical Support Help Desk at: (888) 224-7472

If after contacting the WIC Technical Support Help Desk you are still experiencing difficulties completing the form, per the instructions above, you may print a copy of the form below, complete the form by hand, and mail it to:

California WIC Program
3901 Lennane Drive
Sacramento, California  95834
Attn: Vendor Applications

Last modified on: 11/13/2014 10:23 AM