Wild Carrot Farm Early Bird 2019 Summer Veggie CSA Sign Up Form
Yes! I'd like to sign up for the 2019 CSA season. The summer share will run 21 weeks, from June through October.
Email address *
Other email to receive newsletter also (family member, etc)
Your answer
Have you been a member of Wild Carrot Farm CSA in the past? *
Last Name *
Your answer
First Name *
Your answer
Address
Your answer
Phone Number
Your answer
Summer Full Veggie Share:8-10 items per week (Sliding Scale): $620-$680
Summer Half Veggie Share: 4-5 items per week (Sliding Scale): $365-$400
Price I'd like to pay: (based on your means) *
Your answer
Scholarship Request
Scholarship Donation - I'd like to make a donation to the Wild Carrot Farm Scholarship Fund and help make scholarships available to my neighbors! I would like to donate this amount:
Your answer
Total Price: (the wait list is managed first-come, first served. Price scale does not affect your chance of getting a spot in the CSA) *
Your answer
Thank You!
We look forward to sharing our harvest with you this year and will be in touch soon!

Please mail or drop off your $100 non-refundable deposit (or full payment) to the farm at

511 Upper Dummerson Rd, Brattleboro, VT 05301.

The remaining balance will be due at the first pickup unless you make arrangements for a payment plan or want to pay with EBT.

A copy of your responses will be emailed to the address you provided.
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