CSA Form (Print & Mail)

 CSA Commitment Form 2015 _____________________________________________________ 545 North Main Street, Lanesboro, MA 01237 Mailing Address: P.O. Box 1497, Lanesboro, MA 01237 Store: 413-­‐499-­‐BRAD (2723) Cell: 413-­‐281-­‐4621 michael@bradleyfarm.net www.bradleyfarm.net Name(s)*: ____________________________________________________________________________________ *Person primarily responsible for payment first. This name must be on all checks. Billing address: ______________________________________________________________________________ Delivery Address: (if applicable) ___________________________________________________________ Telephone number(s): ______________________________________________________________________ E-­‐mail address(es): __________________________________________________________________________ Choose the share your are supporting: 1. Regular Share ……………………………….… $625.00 o with 1 dozen egg share ……................. + $85.00 o with delivery …………………………..….. + $50.00 2. Regular Half Share ………………………..… $312.50 20 Shares from June 10 to October 21 o with 1 dozen egg share ……................. + $42.50 o with delivery …………………………..….. + $50.00 3. Summer Share …………………………….…. $312.50 o with 1 dozen egg share ……................. + $42.50 o with delivery …………………………..….. + $25.00 10 Shares from June 10 to August 12 4. Summer Half Share ………………………… $156.25 o with 1 dozen egg share ……................. + $42.50 o with delivery …………………………..….. + $25.00 TOTAL OWED: $ ________________________ TOTAL ENCLOSED: $ ___________________ (Make checks payable to “Bradley Farm”) Do you have friends or relatives who might be interested? We’d be happy to contact them. Name: _____________________________________ Phone: _________________________________________ Mail or email address: ______________________________________________________________________ Thank you for supporting us in providing natural and organic vegetables, fruits, eggs, flowers and groceries. When can I join? There is no deadline, you can sign up anytime and your cost will be pro-­‐rated. Circle a pick-­‐up location: 1. Bradley Farm – Tuesday, Thursday, Friday @ 12pm-­‐6pm 2. Berkshire Mall Farmer’s Market -­‐ Wednesday, Saturday @ 8am-­‐2pm 3. Lee Farmer’s Market @ 12pm-­‐5pm 4. Pittsfield – 199 South St. @ 9am-­‐4pm CSA members commit to picking up their Share at the designated time and location. If you miss, your produce will be donated to the local food bank. If you are going on vacation, we prefer for you to send a friend/neighbor/family member in your place. If you’d like to leave the CSA mid season, we cannot refund your balance without first finding another member to fill your spot as the farm depends on the income to operate. Half of your total is required to reserve your share with this signed Commitment Letter. The remaining balance is to be paid prior to the week of the first Share. If this arrangement is untenable for you: E-­‐mail or call Michael at: michael@bradleyfarm.net; 413-­‐281-­‐4621 to make other arrangements. Signature __________________________________________ (Required) Mail this form to: Bradley Farm CSA P.O. Box 1497 Lanesboro, MA 01237