Please provide the following information. If you are eligible, a WIC counselor will contact you to schedule an appointment.
*If you receive Medi-cal, Cal Fresh, or TANF you may be income eligible.
1. What would you like to do?
Apply (new applicant)
Re-Apply (less than 2 years since last received WIC benefits)
Transfer to Stanislaus County from another county/state
2. If you are a current WIC participant, please provide your family ID or WIC card #
3. Is this a foster family?
4. If this is a referral, what agency are you referring from?
5. First Name
6. Last Name
7. Date of Birth (MM/DD/YYYY)
8. Physical Address
10. Zip Code
11. Phone Number (###) ###-#####
12. Preferred Language
13. Is an interpreter needed for appointments?
14. Are you (Check all that apply):
Have child(ren) under the age of 5 years
Postpartum (had a pregnancy loss less than 6 months ago)
15. Are you currently receiving Medi-cal, TANF, or CalFresh?
16. Which office would you like to go to?
Modesto: 251 E. Hackett Rd, Modesto, CA 95358
Ceres: 1424 Mitchell Rd, Ceres, CA 95307
Mchenry Medical: 1209 Woodrow Ave. Suite B-10, Modesto, CA 95350
Turlock: 1125 N. Golden State Blvd, Turlock, CA 95380
Patterson: 101 W. Las Palmas Ave, Patterson, CA 95363
Oakdale: 1405 West F St, Suite J, Oakdale, CA 95361
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