New Roots Farm Cooperative 2018 CSA Registration Form
STEP 1 of 2 - Personal Information

WE ACCEPT CREDIT/DEBIT CARDS, CHECK, CASH & EBT/SNAP. PAYMENT PLANS AVAILABLE WITH DEBIT/CREDIT CARDS ONLY. PLEASE CHECK YOUR PREFERRED METHOD BELOW.

AFTER SUBMITTING THIS FORM YOU MUST CLICK THE LINK ON THE FOLLOWING PAGE TO MAKE PAYMENT THROUGH PAYPAL. YOU ARE NOT REGISTERED WITH OUR CSA UNTIL WE RECEIVE PAYMENT. YOU WILL RECEIVE AN EMAIL RECEIPT FROM PAYPAL AS PROOF OF PURCHASE.

IF YOU HAVE DIFFICULTIES WITH THIS PROCESS PLEASE SEND EMAIL TO newrootscooperativefarm@gmail.com or call 207-513-0125.

Email address *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Choose Pickup Location *
You may change this location during the season if you wish.
I expect 5 or more signups and request to have shares delivered to my location. Check the box and our business coordinator will get back to you.
What share are you going to purchase? *
At the next step you will make a payment and be able to choose to buy more than one if you wish.
How would you like to pay? Detailed instructions for each payment method on the following page. *
Submit
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