Juice - Concentrate
Product Submission
Company Name
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Contact Person
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E-mail
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Street Address
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City
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State
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Zip Code
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Phone Number
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Area Code
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Enter product information below:
All products must meet current CA WIC Standards
How many products you want add?
1
2
3
4
5
Product Submission 1
UPC Code
*
(12 digits and no space - bar)
Brand Name
*
Product Name
*
Flavor
*
Please Select
Apple
Cranberry
Grape-Purple
Grape-Red
Grape-White
Grapefruit-Pink
Grapefruit-Ruby Red
Grapefruit-White
Orange
Pineapple
Prune
Tomato
Tomato-low sodium
Tomato-spicy
Vegetable
Vegetable-low sodium
Vegetable-Spicy
*Blend-Apple & Grape
*Blend-Cranberry & Apple
*Blend-Cranberry & Grape
*Blend-Orange & Pineapple
*Blend - Other
Container Type
*
Please Select
11.5oz - 12oz Frozen
11.5oz shelf-stable
16oz Frozen
Contains 80% Vitamin C or more
*
Please Select
Yes-Required
Is 100% Juice (Unsweetened)-Requirement
*
Please Select
Yes-Required
Container Meets WIC's Front Labeling Requirements
*
Please Select
Yes-Required
Front label must state 100% Juice and 80% Vitamin C (or more)
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 Submission 2
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Flavor
*
Please Select
Apple
Cranberry
Grape - Purple
Grape - Red
Grape - White
Grapefruit - Pink
Grapefruit - Ruby Red
Grapefruit - White
Orange
Pineapple
Prune
Tomato
Vegetable Cocktail
*Blend - Apple & Grape
*Blend - Cranberry & Apple
*Blend - Cranberry & Grape
*Blend - Orange & Pineapple
*Blend - Other
Container Type
*
Please Select
11.5oz - 12oz Frozen
11.5oz shelf-stable
16oz Frozen
Contains 80% Vitamin C or more
*
Please Select
Yes-Required
Is 100% Juice (Unsweetened)-Requirement
*
Please Select
Yes-Required
Container Meets WIC's Front Labeling Requirements
*
Please Select
Yes-Required
Front label must state 100% Juice and 80% Vitamin C (or more)
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 Submission 3
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Flavor
*
Please Select
Apple
Cranberry
Grape-Purple
Grape-Red
Grape-White
Grapefruit-Pink
Grapefruit-Ruby Red
Grapefruit-White
Orange
Pineapple
Prune
Tomato
Tomato-low sodium
Tomato-spicy
Vegetable
Vegetable-low sodium
Vegetable-Spicy
*Blend-Apple & Grape
*Blend-Cranberry & Apple
*Blend-Cranberry & Grape
*Blend-Orange & Pineapple
*Blend - Other
Container Type
*
Please Select
11.5oz - 12oz Frozen
11.5oz shelf-stable
16oz Frozen
Contains 80% Vitamin C or more
*
Please Select
Yes-Required
Is 100% Juice (Unsweetened)-Requirement
*
Please Select
Yes-Required
Container Meets WIC's Front Labeling Requirements
*
Please Select
Yes-Required
Front label must state 100% Juice and 80% Vitamin C (or more)
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 Submission 4
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Flavor
*
Please Select
Apple
Cranberry
Grape-Purple
Grape-Red
Grape-White
Grapefruit-Pink
Grapefruit-Ruby Red
Grapefruit-White
Orange
Pineapple
Prune
Tomato
Tomato-low sodium
Tomato-spicy
Vegetable
Vegetable-low sodium
Vegetable-Spicy
*Blend-Apple & Grape
*Blend-Cranberry & Apple
*Blend-Cranberry & Grape
*Blend-Orange & Pineapple
*Blend - Other
Container Type
*
Please Select
11.5oz - 12oz Frozen
11.5oz shelf-stable
16oz Frozen
Contains 80% Vitamin C or more
*
Please Select
Yes-Required
Is 100% Juice (Unsweetened)-Requirement
*
Please Select
Yes-Required
Container Meets WIC's Front Labeling Requirements
*
Please Select
Yes-Required
Front label must state 100% Juice and 80% Vitamin C (or more)
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 Submission 5
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name
*
Flavor
*
Apple
Cranberry
Grape-Purple
Grape-Red
Grape-White
Grapefruit-Pink
Grapefruit-Ruby Red
Grapefruit-White
Orange
Pineapple
Prune
Tomato
Tomato-low sodium
Tomato-spicy
Vegetable
Vegetable-low sodium
Vegetable-Spicy
*Blend-Apple & Grape
*Blend-Cranberry & Apple
*Blend-Cranberry & Grape
*Blend-Orange & Pineapple
*Blend - Other
Container Type
*
11.5oz - 12oz Frozen
11.5oz shelf-stable
16oz Frozen
Contains 80% Vitamin C or more
*
Yes-Required
Is 100% Juice (Unsweetened)-Requirement
*
Yes-Required
Container Meets WIC's Front Labeling Requirements
*
Yes-Required
Front label must state 100% Juice and 80% Vitamin C (or more)
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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