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(Office Use Only)ITC WIC PROGRAM SINGLE VENDOR APPLICATION FISCAL YEAR 20162018Date Entered: / / Submission of this application does not constitute authorization to participate in the ITC WIC Program.
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01
Gather all the necessary documents and information that you will need to fill out the ITCA WIC program single application form.
02
Start by entering your personal information such as your name, date of birth, address, and contact details.
03
Provide information about your household, including the number of people living in your household and their relationship to you.
04
Fill out the income section accurately, including any sources of income and the amount received.
05
Answer the eligibility questions based on your income, residency, and nutritional risk status.
06
Provide the required documentation to support your eligibility, such as proof of income or residency.
07
Review and double-check all the information you have entered to ensure its accuracy.
08
Sign and date the application form.
09
Submit the completed ITCA WIC program single application form either by mail or in person to the designated WIC office.
10
Wait for a response from the WIC program regarding your application status.

Who needs itca wic program single?

01
Individuals who are pregnant, breastfeeding, or who have recently given birth.
02
Infants and children up to the age of five who are at risk for nutrition-related health problems.
03
Low-income individuals and families who meet the eligibility criteria for the ITCA WIC program.
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The ITCA WIC Program Single is a form used to apply for the WIC (Women, Infants, and Children) program in the Inter-Tribal Council of Arizona.
Pregnant women, new mothers, infants, and children under the age of five are required to file the ITCA WIC Program Single.
The ITCA WIC Program Single can be filled out by providing necessary information about the applicant's household, income, and nutritional needs.
The purpose of the ITCA WIC Program Single is to determine the eligibility of individuals for the WIC program and to provide them with resources for healthy nutrition.
Information such as household size, income, and nutritional needs must be reported on the ITCA WIC Program Single form.
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