Form

California WIC Eligible
Juice - Bottled
Product Submission
Company Name*
Contact Person*
E-mail*
Street Address*
City*
State*
Zip Code*
Phone Number*
Enter product information below:

All products must meet current CA WIC Standards
UPC Code*
(12 digits and no space - bar)
Brand Name*
Product Name*
Flavor*
Container Type*
64oz Shelf (Only)
Contains 120% Vitamin C or more*
Is 100% Juice (Unsweetened)-Requirement*
Container Meets WIC's Front Labeling Requirements*
front label must state 100% Juice and 120% Vitamin C (or more)
Manufacturer Suggested Retail Price*
Comments
Upload image of product label including:

front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.*
Upload a File
File types pdf, doc, xls, jpg, jpeg, gif, png, mp3, and mpeg allowed - Max upload file size is 5000 KB.
I verify that this product is distributed in California.*

check here
Should be Empty:

Juice - Bottled