Request edit access
2019 CSA Member Info, Form of Payment & Contract Signature
How did you hear about Cotyledon Farm?
Address (All information is confidential, it will not be shared with anyone.)
Pronouns if you wish to share (he/him; they/them; she/her, etc.)
Sliding Scale Pricing-Please choose share size and pricing appropriate to your family size and income
$800 ($40 per week) Sustaining Full Share
$750 ($37.50 per week) Contributing Full Share
$600 ($30 per week) Supporting Full Share
$400 ($20 per week) Sustaining Half Share
$375 ($18.75 per week) Contributing Half Share
$300 ($15 per week) Supporting Half Share
Work Share... There is an application process ~ this does not mean you automatically become a work share
How will you make your payment?
I will pay with a personal check by mail (written out to Cotyledon Farm)
I will pay by cash and wish to make arrangements to do so
I will pay by Food Stamps/EBT and wish to make arrangements to do so
I will pay with both cash/check and Food Stamps and wish to make arrangements to do so
I would like to make arrangements to form a payment plan
I am a confirmed work share and will complete 8 hours of farm work per week during the season in lieu of payment
I will pay through PayPal -Please note! is a 2.9% PayPal fee plus a .30 cent transaction fee that will be added
Each member is asked to do work on the farm during the growing season (5 hours = half share & 10 hours =full share) Please choose a month you would like to complete your hours. There are only 5 slots available for each month.(If you do not want to work on the farm you may opt out and pay a fee -please see below.)
I choose to opt out and pay a fee ($75 half share/// $150 full share)
Would you like to opt out of the work hours?
no, I will do my work hours and have chosen a month
yes, I choose to opt out of the work hours and pay $75 for a half share
yes, I choose to opt out of the work hours and pay $150 for a full share
Would you like to pick up your share in Worcester? There will be an extra charge of $15. The location is: 243 Stafford St, next to Blue Hive. (Parking lot of a local maker space called the WorcShop. We'll send a map and photo of exact pick up spot in May, as it will be an unstaffed pick up in a fairly large industrial complex, formerly the historical Worcester Wire Company.)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service