Frozen Fruit
Product Submission
Company Name
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Street Address
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Phone Number
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Area Code
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City
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State
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Zip Code
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Enter product information below:
All products must meet federal WIC requirements
How many products you want to add?
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Please Select
1
2
3
4
5
Product #1
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Fruit Type
*
Please Select
Apple
Apricot
Banana
Berry, Mixed
Blackberry
Blueberry
Cantaloupe
Cherry
Chilies
Clementine
Cranberry
Currants
Dates
Figs
Fruit, Mixed
Grapefruit
Grapes
Guava
Kiwi
Lemon
Lime
Mango
Mulberry
Nectarine
Orange
Papaya
Passionfruit
Peach
Peacharines
Pear
Pepper
Pineapple
Plum
Pluot
Pomegranate
Prune
Raisins
Raspberry
Strawberry
Tangelo
Tangerine
Watermelon
Youngberries
xOther
If Other Fruit Type (Please Specify)
*
Size
*
Organic
*
Please Select
Yes
No
Package Type
*
Please Select
Bag
Box
I certify that this product has NO added sugars, fats, oils, or salt
*
Please Select
Yes (Required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
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
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #2
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Fruit Type
*
Please Select
Apple
Apricot
Banana
Berry, Mixed
Blackberry
Blueberry
Cantaloupe
Cherry
Chilies
Clementine
Cranberry
Currants
Dates
Figs
Fruit, Mixed
Grapefruit
Grapes
Guava
Kiwi
Lemon
Lime
Mango
Mulberry
Nectarine
Orange
Papaya
Passionfruit
Peach
Peacharines
Pear
Pepper
Pineapple
Plum
Pluot
Pomegranate
Prune
Raisins
Raspberry
Strawberry
Tangelo
Tangerine
Watermelon
Youngberries
xOther
If Other Fruit Type (Please Specify)
*
Size
*
Package Type
*
Please Select
Bag
Box
Organic
*
Please Select
Yes
No
I certify that this product has NO added sugars, fats, oils, or salt
*
Please Select
Yes (Required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
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
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #3
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Fruit Type
*
Please Select
Apple
Apricot
Banana
Berry, Mixed
Blackberry
Blueberry
Cantaloupe
Cherry
Chilies
Clementine
Cranberry
Currants
Dates
Figs
Fruit, Mixed
Grapefruit
Grapes
Guava
Kiwi
Lemon
Lime
Mango
Mulberry
Nectarine
Orange
Papaya
Passionfruit
Peach
Peacharines
Pear
Pepper
Pineapple
Plum
Pluot
Pomegranate
Prune
Raisins
Raspberry
Strawberry
Tangelo
Tangerine
Watermelon
Youngberries
xOther
If Other Fruit Type (Please Specify)
*
Size
*
Package Type
*
Please Select
Bag
Box
Organic
*
Please Select
Yes
No
I certify that this product has NO added sugars, fats, oils, or salt
*
Please Select
Yes (Required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
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
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #4
UPC Code
*
(12 digits and no space - bar)
Brand Name
*
Product Name
*
Fruit Type
*
Please Select
Apple
Apricot
Banana
Berry, Mixed
Blackberry
Blueberry
Cantaloupe
Cherry
Chilies
Clementine
Cranberry
Currants
Dates
Figs
Fruit, Mixed
Grapefruit
Grapes
Guava
Kiwi
Lemon
Lime
Mango
Mulberry
Nectarine
Orange
Papaya
Passionfruit
Peach
Peacharines
Pear
Pepper
Pineapple
Plum
Pluot
Pomegranate
Prune
Raisins
Raspberry
Strawberry
Tangelo
Tangerine
Watermelon
Youngberries
xOther
If Other Fruit Type (Please Specify)
*
Size
*
Package Type
*
Please Select
Bag
Box
Organic
*
Please Select
Yes
No
I certify that this product has NO added sugars, fats, oils, or salt
*
Please Select
Yes (Required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
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
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #5
UPC Code
*
(12 digits and no space - bar)
Brand Name
*
Product Name
*
Fruit Type
*
Please Select
Apple
Apricot
Banana
Berry, Mixed
Blackberry
Blueberry
Cantaloupe
Cherry
Chilies
Clementine
Cranberry
Currants
Dates
Figs
Fruit, Mixed
Grapefruit
Grapes
Guava
Kiwi
Lemon
Lime
Mango
Mulberry
Nectarine
Orange
Papaya
Passionfruit
Peach
Peacharines
Pear
Pepper
Pineapple
Plum
Pluot
Pomegranate
Prune
Raisins
Raspberry
Strawberry
Tangelo
Tangerine
Watermelon
Youngberries
xOther
If Other Fruit Type (Please Specify)
*
Package Type
*
Please Select
Bag
Box
Size
*
Organic
*
Please Select
Yes
No
I certify that this product has NO added sugars, fats, oils, or salt
*
Please Select
Yes (Required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
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
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
California Department of Public Health
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