2011-12 WINTER CSA PROGRAM SIGN-UP FORM

All available spots have been filled.  However, throughout the season, some of our subscriber's cancel their subscriptions for various reasons.  We review our subscriber count periodically and if spots become available we will then email those on our waiting list on a first-come-first serve basis.  If you receive our email and are still interested in becoming a subscriber, please respond ASAP to reserve your spot.  

We recommend that everyone read the "Program Details" section to familiarize yourself with how our CSA program works. 

Please provide the following contact information.  

First Name
Last Name
Mailing Street Address
City
Zip
Home Phone (format: xxx-xxx-xxxx)
Cell Phone (format: xxx-xxx-xxxx)
E-mail

Choose your box preferences below.  

Box Size  

Would you like to pick-up your box or have it delivered? 

If you chose Delivered, please provide your delivery address if different from above Mailing Address:

Delivery Address
City
Zip

If picking up at the farm, which day do you prefer? 

For those that pick-up, what part of the day will you be picking up at the farm? 

How often would you like to receive your box? 

What billing option would you prefer? 

Weekly farm newsletter - Nancy writes a weekly newsletter listing the contents of your box along with other important news about the farm.

For deliveries, please give directions and/or any special instructions:
If you live in a gated community, please give gate code or add us to your permanent gate access list. If we are unable to delivery your box because of denied access, it will be returned to farm for pick-up or donation and you will be charged for non-delivered box.

Where would you like your delivery person to leave your box? (i.e. front porch in cooler).
(For example: Front porch, back porch, in cooler. If you will be leaving a cooler out for your delivery, please make sure it is large enough to hold all perishable items and have some type of ice pack.)

Excludes: You may list up to 4 vegetables you wish not to receive.  
These items will be excluded when part of the daily box content.

Likes: List up to 4 vegetables you especially like which will be used as substitutions for your above Excludes, when applicable.
When we exclude a vegetable, we will try to replace it with one of these.  


Revised: September 12, 2011