CSA Membership Form

RIEHM FARMS 2012 CSA MEMBERSHIP FORM

Member Name(s) ____________________________________________________________

Email Address ______________________________________________________________

(E-mail is our primary form of communication with our members. We will not share your information with any else!)

Contact Phone Number _______________________________________________________

Mailing Address _____________________________________________________________

City, _________________________________________ State __________ Zip___________

Secondary Email Address _____________________________________________________

CSA SHARE OPTIONS: choose all that apply

_____ Standard Vegetable Share - $640 (20) weeks (June 1—October 15) Provides (2) grocery bags a  week of   delicious vegetables—feeds two adults and two children.

_____ Split Vegetable Share - $320 (20) weeks (June 1—October 15) Provides (1) grocery bag a week of delicious vegetables—feeds two adults.

_____ Standard Fruit Share Add-on- $150 (20) weeks (June 1—October 15) Provides (2) types seasonal fruit a week, some grown by neighboring farms.

_____ Split Fruit Share Add-on- $75 (20) weeks (June 1—October 15) Provides (1) type of seasonal fruit a week, some grown by neighboring farms.

_____ One Loaf Spelt Bread Share Add-on- $17.50 (5) deliveries (June 1 - October 15) Provides each month
(1) French baquette, Snail or Italian

_____ Two Loaf Spelt Brad Share Add-on - $35.00 (5) deliveries (June 1 - Oct 15) Provides each month
(1) French baquette, Snail or Italian
(1) Focaccia

_____ Three loaf Spelt Bread Share Ad-on- $65.00 (5) deliveries (June 1 - October 15) Provides each month
(1) French baquette, Snail or Italian
(1) Focaccia
(1) whole loaf slicing bread (high-end loaf, larger in size)

_____ Standard Extended Season - $192 (6) weeks (Oct 21—Nov 28) Provides (2) grocery bags a week of delicious vegetables—feeds two adults and two children. —Due Aug 1

_____ Split Extended Season - $96 (6) weeks (Oct 21—Nov 28) Provides (1) grocery bags a week of delicious vegetables—feeds two adults. —Due Aug 1

PAYMENT PLAN: choose one
_____ Full Payment included
_____ Dual Payment included (1/2 payment now, 1/2 by April 1st)
_____ Triple Payment included (1/3 payment now, 1/3 by Feb 1st, 1/3 by April 1st)
_____ Extended Season (due Aug 1)

CHOOSE A PICK UP LOCATION: choose one
_____ University Of Toledo, Tuesday's 4:15 - 5:30
_____ Martiz Research, Tuesday's 3:00
_____ Promedica, Central Ave Toledo, Tuesday's (tenative 4:15 - 5:30)
_____ Downtown Toledo, open to the public and Lucas County employees (4:30-5:50 exact day & location TBA)
_____ Bowling Green Farmers’ Market
_____ Findlay (tentatively)
_____ Clyde (time and location TBA)
_____ Norwalk at Mossman’s Music Store (time TBA)
_____ Farm from 3:00-6:00  circle one: Wednesday        Thursday         Friday        Saturday
                                                                

QUESTIONS?
If you have any questions, please, do not hesitate to call us at 419-992-4392 or email us at riehmfarms@yahoo.com Either John and Diane will be able to answer any questions you may have. This is an exciting opportunity and we encourage your interest and questions.

SEND IN MEMBERSHIP FORM
Print off this page. Check all that apply. Mail in the completed Membership form with payment to:

Riehm Farms CSA
7244 North State Route 53
Tiffin, Ohio 44883

Your registration will be confirmed through email. Registrations are received on a first-com, first-sever basis. The first payment is due at signup.