Copy and paste on a

Word Document.

________________

 

Please complete and return.

Shares are limited from 12-24 total.

Applications must be returned

and paid in full from

January 1st unti April 22nd.

________________

 

 CSA and Farm Account

Application

Name (s): _____________________________

______________________________________

Address:

(Physical)_____________________________

(mailing) _____________________________

______________________________________

Phone #:______________________________

Cell #: ________________________________

E-mail: ________________________________

Please indicate how you prefer to be contacted from the above options: ______________________________________

Write the amount next to one of the       options listed below:

CSA Farm Share    Value $400:    ______

 

 

Farm Account  ( 10% will be added automatically)

 

                       Value $200-$400:    ______ 

 

Please   complete  the  form   and   return with your payment option. Space is limited so do reserve your share today.

Accepting applications beginning January 1st and no later than April 22nd!

 

Make checks payable to: Holistic Homestead 

Please mail to :                    P.O. BOX 125

                                       Everson, WA 98247               

Thank  You!