Harnett County,
North Carolina

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WIC Signup Request Form

Please fill out the form below to submit your WIC signup request. A WIC representative will contact you within 3 business days to complete the process. Spaces marked with an asterisk (*) are required for proper processing. Your request will be forwarded to: Harnett County (Health Department).

Last Name *
First Name *
Phone *
Best Time to Call *
Referred By
Validation *


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