Please visit our Online Store to pay for your CSA membership online, but don't forget to submit our CSA Sign-Up Form even if you choose to pay online!

Name:
Email:
Phone #:
Street Address:
Address continued:
City, State, Zip:
Requested Share:	Half Share Full Share
Which pick-up location would you like to use?	Champlain Orchards (Shoreham) Cheese Outlet (Burlington) American Flatbread (Middlebury) Almost Home Café (Bristol) Honey Gardens (Ferrisburgh) VT Camera Works (Pittsford) Rutland Regional Medical Center (Rutland) VT Bedrooms (Rutland) Other, please specify below
Would you like a vegetarian or a non-vegetarian share? Non-vegetarian shares will occasionally receive local meat, primarily pork and beef.	Vegetarian Non-vegetarian
How would you like to pay?	By check, one installment (due the week before CSA begins) By check, two installments (due the week before CSA begins and 8 weeks into the CSA) By credit card over the phone - please call (802) 897-2777 x301 to speak with Elissa. By credit card through our Online Store. You can pay by installment using your credit card as well.
How did you hear about our CSA / comments / requested pick-up location?
Would you like to contribute to the Vermont Farm Share program to help low-income households in our community join the farm? Every cent donated goes directly towards the cost of a share. Any size donation helps! For donations to be tax deductible, make checks payable to the Northeast Organic Farming Association of Vermont (NOFA-VT) and write xxx Farm in the check memo. NOFA-VT will match the donation and grant it back to our farm.	I would like to contribute to the Vermont Farm Share program. I would not like to contribute at this time.