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Car Seat Application Procedure:

Please note there is an income eligibility requirement in order to receive a car seat. Income eligibility guidelines are the same as WIC services.

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Applicants should contact our New Bremen Office to set up an appointment.

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The applicant will need to fill out an agency intake form (front & back). This can be done by printing and completing the forms below, or you can do this when you come in for your appointment.

Current Car
Seat Techs:
Judy LaBrake
Shauna Roggie
Melody Tabolt

Before receiving a car seat, the recipient will need to review a training video that explains proper installation and use of the car seat.  Recipients will also learn how to properly install, fit the child to the car seat, and learn proper usage techniques from our certified Traffic Safety Seat Technician.  The recipient will need to have a vehicle present in order to physically install the car seat themselves.

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For more information print and view our the car seat brochure.

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