La Terra Vita CSA Reservation Form 2019
First name *
Your answer
Last name *
Your answer
Email address *
Your answer
Phone number(s) *
Your answer
Mailing address *
Your answer
Vegetable Share options *
Egg Share *
(1 doz./week for 18 weeks) $140. Please indicate how many Egg Shares you want.
Pick-up options *
First share 5/28 (Tue.) or 6/1 (Sat.), then weekly
How did you hear about us?
Your answer
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