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NH Online Forms System - Women, Infants, and Children (WIC)

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Women, Infants, and Children (WIC) Nutrition Program Online Forms

Women, Infants, and ChildrenThe Women, Infants and Children Nutrition Program (WIC) provides nutrition education and nutritious foods to help keep pregnant women, new mothers, infants and preschool children healthy and strong. This online forms page provides access to all required forms to apply for, and become authorized as, a WIC vendor in the State of New Hampshire.  


The following is an overview of the required steps to become a WIC vendor:

IMPORTANT:  You MUST complete Step 1 and be approved before you can complete or submit subsequent forms.

Step 1:  Submit New Hampshire WIC Application for Consideration

Step 2:  Submit New Hampshire WIC Vendor Application

Step 3:  Submit New Hampshire WIC Vendor Agreement

Step 4:  Submit New Hampshire WIC Price Survey     

NOTE: you may be required to complete the General, Restriced or Pharmacy survey based on your vendor status.


The following are definitions of vendor types:

General Vendors - Are allowed to sell all WIC approved products including infant formulas and infant foods.

Restricted Vendors - Are not allowed to sell infant formulas or infant foods.  They are allowed to sell all other WIC approved products.

Pharmacy Vendors - May only sell special ordered infant formulas.  Not allowed to sell WIC approved foods and infant foods.



Return to Department of Health and Human Services Online Forms

Contact Information

Address: Women, Infants, and Children (WIC) Nutrition Program
Division of Public Health Services
New Hampshire Department of Health and Human Services
29 Hazen Drive
Concord, NH 03301

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