WIC Form

WIC Program Interest Form Validated Zip Codes

WIC Eligibility Requirements:

  1. Live in Washington or Oregon
  2. Be a pregnant, postpartum or breastfeeding individual, or the parent of a child under 5 years old
  3. Meet the Income Requirements

Verify that your Zip Code is within our service area

WIC Program Interest Form Validated Zip Codes
Name
Name
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Last
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