Forms

WIC Program Resources for Local Agencies



Notes - Downloading Different Types of Forms
(Excel, Word, PDF)

Excel Forms

Excel forms should be saved to your computer before opening. Click the Save button on the File Download message and select where the file should be saved. Once the file is saved (it will automatically save as an Excel file), you can complete the form in Excel.

Word Forms

Word files should be saved to your computer before opening. Click the Save button on the File Download message and select where the file should be saved. Once the file is saved (it will automatically save as a Word file), you can complete the form in Word. Please fax or e-mail the form as indicated.

Word Forms with Fillable Fields

Word forms with fillable fields should be saved to your computer before opening. Click the Save button on the File Download message and select where the file should be saved. Once the file is saved (it will automatically save as a Word file), you can complete the form in Word. (To select a checkbox, double click on it and select the Checked radio button in the Default Value section. Click the OK button to exit.)

PDF Forms

PDF forms should be printed and completed manually. Please fax or e-mail the form as indicated.


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Note: Local Agencies can use this form to submit an on-line request for data information or assistance with reports. Please select Query/Report from the Type drop-down list.

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  • Exhibit 2C: Request for Increase of Administrative Funds - revised September 2009

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Note: Local Agencies can use this form to suggest potential changes to HuBERT, including: software changes, nutrition education topics, and drop-down list options. The form can also be used to request data information or assistance with reports.

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Note: Local Agencies can use this form as a mailing label to recycle laser printer toner cartridges. Print this page and affix it to the box containing the used laser printer toner cartridge you want to return for recycling. Mail the package by US Mail. Please do not use this label to return defective toner cartridges.

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Note: Use this form to report a change in printer inventory at your local agency. The form is only necessary for printers that were replaced due to failure.

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Note: Local Agencies can use this form to order computer equipment and peripherals on-line.

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Note: Local Agencies can use this form to order miscellaneous supplies such as address labels, printer toner, and printer photoconductors.

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  • Special/Medical Infant Formula Order Form

Note: Local Agencies can use this form to order a special formula from the State WIC office.

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Note: Local Agencies can use this form to submit issues with WIC vendors/stores.

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(Former "WIC Materials in English Order Form" and "Translated & Targeted WIC Materials Order Form".)

Note: Local Agencies can use this form to order WIC materials such as Brochures, Handouts, Videos, Posters, Administrative Forms/Letters and Staff Resources, including those translated into other languages.

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Note: This form can be used to order WIC Outreach Brochures, Fact Sheets, Posters and Magnets.

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