All vendor applicants must accurately and truthfully complete relevant application documents prior to submission. Failure to do so could result in delays with processing or application denial.
Required Documents for Non-Corporate Applicants
According to Georgia WIC policies, vendor applicants owning one store under one corporate entity are classified as non-corporate and issued a two (2) year fixed term agreement. Non-corporate applicants must complete and submit a vendor application and documents listed on the required documents checklist.
Required Documents for Corporate Applicants
According to Georgia WIC policies, vendor applicants owning two or more stores under one corporate entity are classified as corporate and issued a three (3) year fixed term agreement. Corporate applicants must complete and submit a vendor application, one (1) corporate attachment form per store, one (1) corporate information form, and documents listed on the required documents checklist.
- Required Documents Checklist
- Vendor Application and Instructions
- Corporate Attachment Form
- Corporate Information Form
Additional Required Documents
- W-9 Form
- ACH Form
- RD 1062 (corporate)
- RD 1062 (non-corporate)
- Vendor Training Checklist
- Pharmacy Vendor Training Checklist
Approved Infant Formula Suppliers
All vendor applicants and authorized vendors are required to purchase infant formula solely from suppliers selected and approved by Georgia WIC.
Page last updated 03/17/2017