CNC (California Nutrition Corp) Application
Complete applications with all attachments must be submitted by 5:00pm on January 17, 2025. Scores are given based on essay, financial need, ethnicity, and WIC years of service. Awards will be based on scores and advisory committee recommendations. After your submission, your application will be automatically emailed to your WIC Director for approval (at their email you enter). Please contact Lena Workman at lworkman@calwic.org with any questions.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Language of Origin (other than English)
Languages Spoken (other than English)/Your Fluency
Your Fluency In Other Language
Basic
1
2
3
4
Fluent
5
1 is Basic, 5 is Fluent
Ethnic Background
*
African American
Asian/Pacific Islander
Caucasian
Latinx
Native American
Other
Employment & Program Information
Name of WIC Agency Employer (Choose one)
*
Please Select
Alameda County
Alliance Medical Center
American Red Cross
Ampla Health
Antelope Valley
Axis Valley Community Health
Berkeley, City of
Butte County
Camino Health Centers
Clinica Sierra Vista
Community Action Partnership
Community Bridges
Community Medical Centers
Contra Costa County
CRP WIC - Sacramento
Del Norte County WIC
Delta Health Care
E-Center
El Dorado County
Fresno County EOC
Gardner Family Health Network
Glenn County
Humboldt County
Indian Health Center of Santa Clara
Inland Behavioral & Health Center WIC
Innercare
Inyo County
Kings County Health Department
La Clinica de la Raza
Long Beach Department of Health
Madera County Dept. of Health
Marin County
Mendocino County
Merced County
Mono County
Monterey County
Napa County
Native American Health Center
Nevada County Health Department
Northeast Valley Health Corp.
Northeastern Rural Health Clinics
Orange County WIC
Pasadena WIC Program
PHFE WIC
Placer County Health Department
Planned Parenthood Orange County
Plumas Rural Services
Riverside County Dept. of Public Health
Riverside/San Bernardino Indian Health Services
S.D.S.U. Foundation
Sacramento County
San Benito Health Foundation
San Bernardino County
San Francisco, City and County
San Joaquin Co. Public Health Srvc.
San Luis Obispo Health Agency
San Mateo County
San Ysidro Health Center
Santa Barbara County
Santa Clara County
Scripps Health/Mercy Hospital
Shasta County
Sierra County Health Department
Siskiyou County
Solano Co. Health & Social Srvc.
Sonoma County WIC
Sonoma County Indian Health
Stanislaus Co. Health Services
Sutter County Health Department
Tehama County Health Services Agency
The Lundquist Institute
The Resource Connection
Tiburcio Vasquez
Toiyabe Indian Health Project
Trinity County
TrueCare (fka North Co. HS)
Tulare County
Tuolumne County Health Dept.
United Health Cntrs. Of San Joaquin
United Indian Health Services, Inc.
Ventura County
Watts Healthcare Corporation
West Oakland Health Council
Yolo County
Your WIC Director Email (an email will be automatically sent to this address to approve your application)
*
name@agency.org
Hire Date At WIC
*
-
Month
-
Day
Year
Date
Full Time or Part Time (choose one)
*
Full Time
Part Time
If Part Time, average number of hours per month at WIC
Permanent or Temporary Position (choose one)
*
Permanent
Temporary
Have you ever applied for a CNC Scholarship under any other name? If yes, please enter the name
Choose what program you are enrolled in
*
WIC Dietetic Internship
Other Dietetic Internship
Graduate School
Undergraduate School (Dietetics, Nutrition, Other Related Major)
If Other Dietetic Internship, please list program
If Graduate or Undergraduate School, enter field of study
Start date of your program
*
-
Month
-
Day
Year
Date
Expected completion date of your program
*
-
Month
-
Day
Year
Date
Upload Essay, Recommendations, and Financial Statements
Essay 500-1000 words entitled "My Professional Nutrition/WIC Career Goals" (cut and paste from a document)
*
Financial Needs Statement (one to two paragraphs)
*
Upload Financial Budget Worksheet
*
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of
Upload Completed Recommendation from WIC Program Employer
*
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Upload Completed Recommendation Form from University or Dietetic Internship
*
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Upload Verification of enrollment in your program (e.g. current class schedule, acceptance letter into DI program)
*
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Upload Picture
*
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of
Signature
*
I hereby certify that all the information provided in this application is true and correct.
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