Full Cellar Farm 2017 Membership Form
Email address
Basic Information
Name
Your answer
Street Address
Your answer
City, State, ZIP
Your answer
Phone Number
Your answer
Choose your Membership
If you'd like more than one of any given share, please indicate that in the Notes field below.
Sign me up for the weekly vegetable share! ($500)
23 weeks of vegetables, chosen by you! To sign up, please enter the number of shares you'd like to purchase.
Your answer
Sign me up for the Fill Your Cellar share! ($300)
The "Fill Your Cellar" share includes bulk quantites of over a half-dozen preserving and storage crops. See http://www.fullcellarfarmoregon.com/p/fill-your-cellar-new.html for details. To sign up, please enter the number of shares you'd like to purchase.
Your answer
I'd like to contribute to the Full Cellar Farm scholarship fund!
Scholarship donations will be used to help members in need of financial assistance. If you'd like to contribute, please enter the amount below.
Your answer
Total amount due
(Total amount of shares plus optional donation)
Your answer
Notes
(Payment questions, names and email addresses of anyone you're sharing with, or anything else you'd like to note!)
Your answer
Method of Payment
Please choose one
Choose Your Pickup Spot
(Pickup days & times are listed in parentheses.)
How did you hear about the farm?
Your answer
Thank you for signing up for the Full Cellar Farm CSA! I look forward to growing for you in 2017!
Payments can be mailed to:
Full Cellar Farm
c/o Emily Cooper
250 SE Vista Ave #31
Gresham, OR 97080
A copy of your responses will be emailed to the address you provided.
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