Vendor Application and Forms

​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. These documents are fillable (can be typed into before printing).

Grocer Applicants

• Vendor Application and Instructions

Pharmacy Applicants

• Vendor Application and Instructions

Remaining Required Documents for Grocer and Pharmacy Applicants

• Required Documents Checklist
• W-9 Form
• ACH Form 
• RD 1062

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. These documents are fillable (can be typed into before printing).

Grocer Applicants

• Vendor Application and Instructions

Pharmacy Applicants

• Vendor Application and Instructions

Remaining Required Documents for Grocer and Pharmacy Applicants

• Required Documents Checklist
• Corporate Attachment Form
• Corporate Information Form
• W-9 Form
• ACH Form   
• Vendor Training Checklist
• Pharmacy Vendor Training Checklist
• RD 1062 

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.

• Approved Infant Formula Suppliers (Updated September 2022)

Page last updated 5/18/2023