WIC Retailer Application

Retailer Application
Each Retailer store applying for the WIC Authorization must complete a WIC Authorization Application. Retailer applicants must complete and submit all the required application forms to the State WIC office. All information MUST be complete.

Complete Retailer Application Packet
The Retailer application packet provides an overview of the Missouri WIC Program as well as specific instructions for completing the application. Please download the application packet prior to completing Retailer Authorization Application.

Retailer Food Price List and Stocking Survey
Each applicant must complete and return the Food Price List and Stocking Survey with the Retailer Authorization Application. Stores must list the current shelf (not sale) prices of all WIC approved foods the store currently has in stock. Stores must list the quantity in stock of all WIC approved foods in the store. The person completing the Food Price List must sign and date it where indicated.
Caution: Applicants must stock the minimum varieties and quantities for each food category listed on the pages.