Stone's Throw CSA 2010 Registration Form
Member Name(s) _________________________________________________________
Address _________________________________________________________
City, State, ZIP _________________________________________________________
Phone(s) _________________________________________________________
Email(s) _________________________________________________________
Can this information be shared with other Stone’s Throw CSA members? _________________________
Do you need help in finding another member to split your share with?_________________________________________
Which pick up day do you prefer (limited availability)? Tuesday _______ Saturday ________
Do you have any special area of interest for your Shareholder Work Hours? Field Work _____ Distribution _____ Administrative______ Other (specify) _____ (Some jobs are limited in their availability and fill quickly. You will receive additional information on each area.)
Are you interested in our “Workshare” program where you trade a portion of your share cost for your labor? (Acceptance in this program is subject to approval by the Stone’s Throw CSA Steering Committee.) If so, briefly describe your situation and any skills you can offer to the farms (attach an additional sheet of paper or use the back of this form)_____________________________________________________________________________________________
Are you interested in running a workshop for other CSA members? On what topics?
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Are you interested in applying for assistance through the Stone Soup Fund? If so, attach a letter explaining your situation for consideration. Applications must be received by April 15th and will be reviewed confidentially.
Would you need to pay for your share via the SNAP Program? ________________________________________________
Make Checks Payable to: Stone’s Throw CSA, 96 Eight Lots Road, Sutton MA 01590
| |
ü |
Amount |
| I would like to join Stone’s Throw CSA for 2010, Annual Membership Fee, $30 |
|
|
| I would like to buy a vegetable share. |
|
|
| I wish to pay the full share payment of $550 at this time |
|
|
| I wish to pay under the installment plan: $184.34 due April 1, $184.33 due May 1 and $184.33 due June 1. At this point I am enclosing $_________________ in installment payments. |
|
|
I am unable to meet my work commitment and am donating $80 per regular share
|
|
|
| I commit to completing my work commitment. Initial here ____________ |
|
|
| I would like to contribute $_______________ to the Stone Soup Fund to help my neighbors in need (not tax deductible) |
|
|
| Total enclosed |
|
|