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Vermont WIC Family Partner Application

Welcome! Parents and caregivers who receive WIC offer valuable ideas and we hope to partner with you to improve the Vermont WIC Program. If you would like to become a WIC Family Partner, please take a few moments to complete and submit this form and our Family Partnerships Coordinator will be in touch with you soon. If at any time you have questions, please email . Your information will not be shared outside of the Vermont WIC program.

We are thrilled you are here! "Together we can do so much."

1. Will you allow your contact information to be shared with other Family Partners?    
  *This question is required.
6. Below are some ways Family Partners might work with us to improve the Vermont WIC Program.  Please check all that may be of interest to you: