Full Plate Farm Collective ~ 2017-18 Healthy Food For All Solidarity (subsidized) WINTER CSA Share Application ~
Sign me up! For 12 weeks, November 30th through March 1st (with a holiday break from 12/22 thru 1/10) of abundant locally grown, organic produce ALL WINTER LONG!!!
Spaces are limited and reserved on a first come, first serve basis. To ensure your space, fill out and submit this application and send in your check today!

Send deposit check to:
Full Plate Farm Collective: PO Box 6898 Ithaca, NY 14851
To pay by credit card, please use the PayPal buttons on the right hand side of this webpage. To pay using Cash or EBT-Food Stamps, or if you can't see the PayPal buttons, please contact us.

***PLEASE NOTE- Your space in the CSA is NOT reserved until your DEPOSIT is RECEIVED by the farm.***
Thanks!

Questions? Please get in touch! phone: 607.379.2866 or email: info@fullpatefarms.org

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SPECIAL INFORMATION regarding our shares:

Full Plate Farm Collective offers Boxed WINTER CSA Shares. All shares are available by mid-day on Thursdays. All pick up sites are self-serve.

Shares can be picked up at:
Stick and Stone Farm (1605 State Route 96, Ithaca)- 9am -9pm Thursday through the following Wednesday
Three Swallows Farm (23 Nelson Rd, Danby)- noon- 9pm Thursday through the following Wednesday
Remembrance Farm (6294 Searsburg Rd, Trumansburg)- 9am -9pm Thursday through the following Wednesday

If your physical mobility is restricted, home or group delivery may be an option, please contact us for details.

ALL winter shares are priced at:
$160 (can be paid in full or paid using a payment plan, details below)

Name
Your answer
Address
Your answer
Phone number(s)
Your answer
Email
Your answer
Income Eligibility Charts
please refer to the charts below and confirm that you are income eligible for the HFFA Solidarity CSA Share.
My household is income eligible for HFFA Solidarity CSA Shares
Please refer to the above charts and confirm that your household is income eligible. Eligibility is determined by gross income (before taxes) and family size.
I am applying for the following Full Plate Farm Collective CSA Share
Please refer to the share descriptions above. Please make sure you check the correct share type!
I understand that this is a binding agreement, on my part to provide financial support to the farm and for the farmers to provide me with food. I also understand that farming is a natural process and that weather may influence the amount and diversity of produce I receive.
Please read and indicate if you agree to the above statement
Please indicate your preferred PICK-UP location
I would like to pay for my CSA using EBT-Food Stamps
If using EBT to pay for your deposit, please contact the farm.
Important note regarding EBT! HFFA is happy to take EBT payments for your CSA share! EBT payments can be made at Greenstar Cooperative Market. After making your EBT payment at Greenstar, you MUST save your receipt and provide it to your farmer ASAP as proof of payment. HFFA CSA members are also eligible to become members of Greenstar's FLOWER program. FLOWER members receive a 15% discount on most products purchased at Greenstar and membership provides an additional way to verify CSA payments made via EBT at Greenstar.
for more information on the FLOWER program please visit http://www.greenstar.coop/flower or contact healthyfoodforall.ithaca@gmail.com. We will be in touch with more info on how to activate FLOWER membership.
Healthy Food For All is made possible through grants that require us to report the following information. Your answers will remain strictly confidential. Thank you.
How many adults are in your household?
Your answer
How many children are in your household?
please also indicate their ages
Your answer
Do any of the children in your household attend any of the following:
please check ALL that apply
Please indicate which programs you participate in:
please check all that apply
Did you participate in a CSA last year?
How did you hear about Healthy Food For All?
please check all that apply
On average, how many servings of fruits and vegetables do you consume in a week?
1 serving = 1 cup salad or 1/2 cup cooked vegetable or 1/2 cup fruit
Your answer
On average, how many servings of fruits and vegetables do the children in your household consume in a week?
Your answer
On average, how many different types of vegetables do you consume in a week?
Your answer
On average, how many different types of vegetables do the children in your household consume in a week?
Your answer
What ethnicity do you identify with?
Your answer
How often to you check your email?
***PLEASE NOTE- Your space in the CSA is NOT reserved until your DEPOSIT is RECEIVED by the farm.*** Thanks!
if you plan on paying your deposit with EBT/Food Stamps, please contact the farm
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