Apply To WIC (Women, Infants & Children)

Name of Applicant
Date of birth of the youngest child you are applying for, or your date of birth if you are applying for yourself.(Required)
I am already enrolled in WIC or have been enrolled in the past(Required)
By clicking submit, I am allowing the electronic transmission of the information above to the Department of Public Health. I understand by selecting a method of contact and providing my phone number/email address that I am giving consent for the WIC program to contact me. I understand that the Department of Public Health will share this information with a local WIC agency in my area, who may use this information to screen my WIC eligibility. Please see the Mass.gov/privacy policy for further information on the electronic transmission of information to the WIC program. I also understand that by submitting this information, I am not guaranteed enrollment in the program. This institution is an equal opportunity provider.(Required)