Michigan Farm to Family *CSA w/ Providence Farm Sign-Up Form (*CSA stands for Community Supported Agriculture)
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This program will provide a box of farm-fresh organic produce every-other-week through Thanksgiving.  It is meant to help a family of 2-4 supplement their groceries.  Boxes are $10.00 per week for EBT card-holders who have SNAP  benefits.  (Providence Farm Boxes are normally $40 per box.). - - Participants who enjoy fresh vegetables will especially like this opportunity.  Each Farm Box comes with a description of items in the box, recipes for each item, and storage tips for each item for ease of use.
This program is made possible through partnership w/ Michigan Fitness Foundation, which has created "Michigan Farm to Family CSA" for Michigan families to have better access to local farm-fresh produce.
Please enter you EBT card number.  If you do not have EBT card number, this is not for you. *
Check which share type you are choosing: *
Shares begin the Week of June 20th and ends the week of October 24th.     This is a every other week share (10 weeks total).
Membership Agreement
I understand: • The 2023 CSA program runs for 12 weeks, Starting the week of June 20, to Week of Oct 24th.  This is biweekly (every other week) Share. *
I understand: • I commit to participating for all 10 weeks. If I can’t pick-up on my pick-up day... IF for some reason, I cannot, I will make arrangements to pick it up in the next few days. *
A share costs $10.00 each week which I will need to pay with my EBT card. (This includes about 3/4   discount off the share price of $40.) *
I will Pick Up My Share (Please Choose 1 option below) *
First & Last Name: *
Full Name of Spouse or Partner that is listed under the same EBT card.  If not, please respond:  None *
Contact E-Mail Address *
Address (Please include street address, City & Zip code) *
Phone Number *
Preference for phone contact *
What Kind of reminder would you like? *
Besides you, how many people currently live in your household?  This just lets us know how many people the program is reaching. *
Typed Signature *
Date *
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