To fill out form online, click in the box you want to begin typing in then tab through the rest of the form fields. After filling out all information, print the form, sign and date.
- All sections must be filling out in ink. (Black or Blue)
- All sections must be completed. (Do not leave anything blank)
- Application must be signed and dated.
If presenting the application in person, you must have one of the following documents:
- A current state issued driver’s license that includes a photograph.
- A state issued identification card that includes a photograph
- A current U.S. military identification card that includes a photograph.
- A U.S. passport with current photograph.
- For students in high school or below, a current school identification card/document with a photograph
If mailing the application, it must be notarized by a notary public and include a self stamped addressed envelope.
WCHD accepts cash, checks, cashier’s checks, and money orders. We do not accept checks from outside the state of Missouri. If ordering from outside Missouri please send money order or cashier’s check only.
(Note: Extra postage is required for more than 3 copies)
Checks must contain the following information:
- Account holder’s street address (No P.O Boxes)
- Account holder’s phone number
- Account holder’s date of birth
- Account holder’s social security # or driver’s license #
No third party checks accepted.