Boistfort Valley Farm CSA: Sign up!

Please fill out this form, print it & mail it with your check to apply
for membership in our November to May CSA program.

* Cost of CSA is $420, for seven Monthly deliveries, November to May.
  OR $300, for five Monthly deliveries, January to May.
* Please note that all South end deliveries (Tacoma and points south) will take
  place on Wednesdays. Seattle area deliveries will take place on Thursdays.
* Produce is packed in boxes and delivered to a central location in your
  neighborhood. Please return boxes in usable condition from the
  previous month when picking up your next delivery.

name: ___________________________________________________________
email: __________________________________________________________
address: ________________________________________________________
city: __________________________ state: ____ zip: _______________
phone: __________________________________________________________

November to May CSA Share
amount enclosed:  ___ $420 full payment, 7 deliveries (Nov-May)
		  ___ $300 full payment, 5 deliveries (Jan-May)
		  ___ $150 deposit for: ___ Nov-May ___ Jan-May
Preferences (check any that apply):
    ___ no cheese  ___ no wheat/gluten  ___ no coffee  ___ decaf

Honey
	___ 1# $7.50 (plastic jar)    	___ 1 pint $12 (glass jar)
	___ 1 quart $22 (glass jar)
	Delivery:  ___ November or ___ December

Notes:


please circle drop location:     Ballard     Burien
	Capitol Hill North     Capitol Hill South     Fremont
	Hilltop Children's Center (staff and families only)
	Kirkland     Mercer Island North     Mercer Island South
	Olympic Sculpture Park     Queen Anne     Shoreline     
	Wizards of the Coast (employees only)     Kent     Wedgwood
	West Seattle     Tacoma     DuPont     Intel (employees only)
	Olympia Central     Olympia Capitol
	Olympia: Pritchard Building (State employees only)
	Olympia: Natural Resources Building (employees only)
	Olympia: Cherry St Plaza (employees only)
	Department of Health in Tumwater (employees only)
	Centralia     Chehalis     Boistfort Valley Farm     NE Portland
suggest other: __________________________________________________

I understand and agree to the purchase conditions and payment schedule.
I also understand that availability of crops and their quantities are
approximate and may vary with seasonal conditions (please sign).

_________________________________________________________________
	
how did you hear about us? _________________________________________

Please print this form out & send it, along with your check, to:
	Boistfort Valley Farm
	PO Box 130
	Curtis, WA 98538

phone:  (360) 245-3796
website: www.BoistfortValleyFarm.com