2014 winterfell acres csa membership form

Winterfell Acres LLC 2014 CSA Membership Form Fill out and mail with payment to: Winterfell Acres 1120 N. Pleasant View Rd. #202 Middleton, WI 53562 Member Information: Name ______________________________________ Address ___________________________________ City ___________________________ State ______ Zip _____________ Phone____________________ Email ______________________________________ Your receipt and all member communication will be via email. Please add [email protected] to your email contacts. Share Selection: 20 boxes June 3 October 14 o Full Share $600 o Small Share $400 Payment Options: o Full payment Include full payment today o Two payments Include two equal checks dated today and 5/1/14 Pick Up Site Selection: Deliveries are on Tuesdays o Fitchburg: CrossFit Atavus (6060 McKee Road) 5:308pm o Middleton: Blue River Chiropractic (346 Junction Road) 56:30pm Member Commitment: By joining Winterfell Acres CSA, I acknowledge my commitment to share in the risks and bounty of this farm community for the full season. I also agree to pick up my CSA share during the designated pick up day and time unless other arrangements are made. Signature Date

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Page 1: 2014 winterfell acres csa membership form

Winterfell Acres LLC 2014 CSA Membership Form

Fill out and mail with payment to: Winterfell Acres

1120 N. Pleasant View Rd. #202 Middleton, WI 53562

Member Information:

Name ______________________________________

Address ___________________________________

City ___________________________ State ______

Zip _____________ Phone____________________

Email ______________________________________ Your receipt and all member communication will be via email. Please add [email protected] to your email contacts. Share Selection: 20 boxes June 3-‐ October 14

o Full Share $600

o Small Share $400

Payment Options:

o Full payment-‐ Include full payment today

o Two payments-‐ Include two equal checks dated today and 5/1/14

Pick Up Site Selection: Deliveries are on Tuesdays

o Fitchburg: CrossFit Atavus (6060 McKee Road) 5:30-‐8pm

o Middleton: Blue River Chiropractic (346 Junction Road) 5-‐6:30pm

Member Commitment:

By joining Winterfell Acres CSA, I acknowledge my commitment to share in the risks and bounty of this farm community for the full season. I also agree to pick up my CSA share during the designated pick up day and time unless other arrangements are made. Signature Date

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