PROMISED LAND CSA 2012 MEMBERSHIP FORM

PRODUCE SHARE COST: $500       FRUIT SHARE COST: $225

A $200 deposit is required for each produce share for the 2012 season. No deposit is required for fruit shares. This will secure your produce share/s until May 1st when the remaining balance is due. If your balance is not paid in full by May 1st your deposit will be promptly refunded and your share forfeited unless prior arrangements are made well in advance of this date. There are approximately 25 weeks in the produce season and approximately 20 weeks in the fruit share season.  We are looking forward to a new year to grow!

 

 

Name:__________________________________________________________     

 Street Address: ___________________________________________________

City/Town: _________________________________ Zip: _________________
Phone: __________________________      _____________________________
Email Address: ____________________________________________________

 

If splitting a share please complete contact information for additional person/s for communication and billing purposes.

Name: ___________________________________                   

Phone: ___________________________________                   

Email Address: _____________________________                  

Pick up site:
         _____ Farm                                             >  Promised Land farm is at 2112 Co. Line Rd. Alden                                 
         _____ Park School                                  >  The Park School is at 4625 Harlem Rd. Snyder
         _____ Massachusetts Avenue Project     > MAP is at 271 Grant St. Buffalo
         _____ Other ___________________     > for employees of E&E and Rich Products OR

                                                                          > Lancaster site which is at 110 Pleasant Avenue

         _____ *Home Delivery      

*Please confirm the availability of home delivery; it is based on proximity to our delivery routes.

                                                                               

                                                                         

NUMBER OF SHARES DESIRED:

                                                                                                  

PRODUCE SHARES:  __ @ $500                                                                                                                                                                                                                                                   

                                                                                   Mail this form with deposit to : Promised Land CSA                                         

FRUIT SHARES:         __ @ $225                                                                         3105 County Line Rd.

                                                                                                                                      Corfu NY 14036                                                                                           

HOME DELIVERY     __­    $125                                                                         (585)599-3462

 

TOTAL                     $_______

 

LESS DEPOSIT      - $_______   Please make checks payable to: Daniel Oles                                    

  ($200 for each produce share)

                                                                               

REMAINDER DUE   $_______   * BEFORE MAY 1ST 2012

 

 

~ PLEASE COPY AND SAVE THIS FORM FOR YOUR OWN RECORD  ~

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