Teletask

WIC Application

Please provide the following information. If you are eligible, a WIC counselor will contact you to schedule an appointment.

**Gross Income**
185% Federal Poverty Level
Effective April 1, 2025 - June 30, 2026
Number of persons in Family Unit **	Annual	Monthly	Twice Monthly (Semi-Monthly)	Bi-weekly	Weekly
1	$28,953	$2,413	$1,207	$1,114	$557
2	$39,128	$3,261	$1,631	$1,505	$753
3	$49,303	$4,109	$2,055	$1,897	$949
4	$59,478	$4,957	$2,479	$2,288	$1,144
5	$69,653	$5,805	$2,903	$2,679	$1,340
6	$79,828	$6,653	$3,327	$3,071	$1,536
7	$90,003	$7,501	$3,751	$3,462	$1,731
8	$100,178	$8,349	$4,175	$3,853	$1,927
Each add’l family member add	$10,175 per added family member	$848 per added family member	$424 per added family member	$392 per added family member	$196 per added family member

**Unborn fetuses may be counted toward household size.
Families who receive Medi-Cal/Medicaid, CalFresh/SNAP, or CalWorks may qualify.

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

Enroll newborn(s)

2. If you are a current WIC participant, please provide your family ID or WIC card #

3. Is this a foster family? *

Yes

No

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 *

9. City *

10. Zip Code *

11. Phone Number (###) ###-##### *

12. Preferred Language *

13. Is an interpreter needed for appointments?

Yes

No

14. Are you (Check all that apply): *

Pregnant

Breastfeeding

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? *

Yes

No

16. Which office would you like to go to? *