La Terra Vita CSA Reservation Form 2019
* Required
First name
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Your answer
Last name
*
Your answer
Email address
*
Your answer
Phone number(s)
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Your answer
Mailing address
*
Your answer
Vegetable Share options
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Full Share (2 adults) $595
Individual Share (1 adult only) $450
Required
Egg Share
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(1 doz./week for 18 weeks) $140. Please indicate how many Egg Shares you want.
0
1
2
3
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5
Pick-up options
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First share 5/28 (Tue.) or 6/1 (Sat.), then weekly
PDX, Saturdays 8:30am-2pm, PSU market
SALEM, Tuesdays 4-6:15pm, central location
Stayton, Tuesdays 3pm, St Mary/Regis
Farm, Tuesdays anytime from 2pm
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