Please fill out the Family Information Form and an additional application for each person applying for WIC. Print and bring these to your appointment along with your ID and proof of total monthly income for your household.

  • Family Information Form - All applicants need to fill out this form, one per family.
  • Post Partum Women Application - Application for women with a baby (less than six months old) taking formula or women who are breastfeeding a baby (that is less than one year old.)
  • Child Application - Fill out an application for every child in the family who is one-year to five-years old.
  • Pregnant Women Application - Application to be completed by women who are pregnant.
  • Infant Application - Fill out an application for every infant in the family who is less than 12 months old.

* Infant Special Prescription form. Please print and have your physician complete the form. Find the ENPR form HERE.

Proof of Income Accepted:

  • Denali KidCare
  • Medicaid
  • Last 30 Days of Pay Stubs
  • ATAP
  • LES
  • Unemployment Papers
  • Permanent Fund Dividend
  • Child Support
  • OCS Fostercare Paperwork