CSA Order Form

CSA Order Form
Available shares
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Vegetables Share
Regular share - approximately 15 lbs
$10.00Amount

Fruits Share
Regular share - approximately 15 lbs
$10.00Amount

Eggs Share
Per dozen
$6.00Amount

Chicken Share
Regular share - approximately 18 lbs
$20.00Amount

Pork Share
Small share - approximately 15 lbs
$30.00Amount

Turkey Share
Small share - approximately 12 lbs
$30.00Amount

Total
$0.00
Name
First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Mode of Payment
Other
Payment Plan
Drop Off Location
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
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