WIC Vendors - Grocery

Forms for applicants
Forms for approved vendors

Any owner of a grocery store or pharmacy located in Wisconsin may apply for authorization as a WIC grocery vendor. WIC authorization does not transfer to a new owner when a change of ownership occurs. Vendors shall not accept drafts until all application requirements are met, including completing forms and submitting supporting documents, passing a site visit, completing a training program and receiving an authorization letter from the WIC Program. Completion of the application does not guarantee WIC vendor authorization. Submission of false information will result in denial of the application.

Conditions of Eligibility Vendors Must Meet

1. An acceptable history with WIC and other food and nutrition service programs of the USDA.

2. Charge a price for a standardized combination of foods which is comparable to the average price charged for those foods by other vendor applicants in the project service area in which the grocery store is located, as determined by the state WIC office.

3. Have a satisfactory site visit by the state or local WIC project wherein it is determined that:

1. the store meets the minimum stock requirements on shelves or in coolers in the customer area of the store as follows:

Milk	20 gallon containers (white)
Cereal	24 boxes (6 different cereals; 4 boxes of each)
Juice	28 containers (combination of at least 1 type of frozen 11.5 -12 oz. concentrate and at least 1 type of single-strength juice in 46 oz. can or plastic bottle)
Cheese	Four pounds, 2 blocks of 2 different cheeses (NOTE: more than four blocks may be needed to meet the four pound requirement)
Eggs	Eight one-dozen cartons, white, brown, any size or grade
Peanut Butter	Four 18 oz. jars
Dried Peas, Beans & Lentils	Four pounds, 2 pounds of at least 2 different types
Infant Cereal	Two types, six 8 oz. boxes
Infant Formula	62 cans of 13 oz. concentrated liquid Good Start® Supreme dha & ara                              OR  20 cans of 12 oz. powder Good Start® Supreme dha & ara                            OR 31 cans of 13 oz. concentrated liquid Good Start® Supreme dha & ara and 10 cans of 12 oz. powder Good Start® Supreme dha & ara

2. prices are marked on the food containers or posted in the immediate area where foods are kept in the customer area of the store;

3. prices are not substantially higher than those listed on the application;

4. the store is not in violation of applicable federal, state or local health protection laws and ordinances;

5. authorized foods are not older than the expiration date indicated on the package or are otherwise fresh.

4. Following an acceptable site visit, participate in a training program at a location designated by local WIC Project staff. A signed contract, authorization letter, vendor stamp, and educational materials will be distributed at the training session.

Duration of Authorization

Initial authorization expires one year after the date on which the authorization was granted. Application for reauthorization is mailed the first of the month prior to the anniversary month.

Application Materials

• Agreement Between the State of Wisconsin and the Vendor. (PDF, 27 KB)
  Two copies are needed, and both copies must be signed and returned. A copy signed by the Department will be returned when the store is authorized.

• Wisconsin WIC Program Retail Vendor Application and Instructions. (PDF, 42 KB)
  Keep a copy of each page of the completed application for your records.

• Wisconsin WIC Retail Vendor Application Amendment. (PDF, 17 KB)
  Use this form to update your application information after it has been approved. 

• Stock Price Survey. (PDF, 53 KB)
  Keep a copy of each page of the completed stock price survey for your records.

• WIC Retail Vendor Annual Food Sales Survey. (PDF, 29 KB) 

• WIC Approved Foods Guide. (PDF, 26 KB)

• WIC Authorized Infant Formula Suppliers. (PDF, 9 KB) 

Other Documents Required

1. Copy of the bill of sale, business lease agreement, agreement to purchase, deed or other legal proof of ownership of business for purchased businesses; or business agreement, lease, deed, franchise agreement or other documentation for stores in new or vacant buildings; or copy of pharmacy license for pharmacies.

2. Copy of the License as a Retail Food Establishment (Food Dealer's License).

Regulations, Statutes and Administrative Rules

• WIC Vendor Manual (PDF, 1.4 MB) (Large file; may download slowly)   

• Title 7 CFR Part 246 as of January 1, 2005. (PDF, 297 KB)
  Or search for "7CFR246" in the Code of Federal Regulations. (exit DHFS)

• Section 253.06, Wisconsin Statutes. (exit DHFS)

• Chapter HFS 149, Wisconsin Administrative Code.

Determination Period

Applications are reviewed within 90 days of receipt of complete applications. If the application is not complete, a notice of incomplete items will be sent and the application will not be processed further. An application returned due to incompleteness may, following completion, be resubmitted within 15 days to the State WIC Office, or a new application may be submitted at any time.

Vendor Forms 

• Complaint form

• Vendor supplies request

Department Contact

WIC Vendor Integrity
PO Box 2659
Madison, WI 53701-2659
608-266-6912

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Last Revised:  June 18, 2008