Lowlands Farm

2019 Flower CSA Order Form

Name______________________________________________________________________________________

Address____________________________________________________________________________________

City________________________________________________________ Zipcode________________________

Phone____________________________ Email(s)__________________________________________________

Check your pick-up location

_____ On the farm (Snohomish) - Tuesdays

_____ In Mill Creek - Tuesdays

_____ In Ballard - Tuesdays

FLOWER MEMBERSHIP FEES for 2019

Weekly (10 bouquets):                       _____ Pay in Full: $180                

Bi-weekly (5 bouquets):         _____ Pay in Full: $108

Dahlia Share (4 bouquets):        _____ Pay in Full: $80

Please include recipient's name and email if the flower share is a gift!

____________________________________________________________________________________

Total amount enclosed _____________________________

(Credit/Debit, online payments will be available soon!)

Please make checks out to “Lowlands Farm”

⏯  I have read,  understood, and agree to the details of the Flower CSA Membership

Signature______________________________________________ Date________________

Please Print, Sign and Return this page with your check to:

Lowlands Farm, 10890 Elliott Road, Snohomish, WA 98296