Misty Meadows Farm CSA
2012 Payment Form
Name:________________________________________________________________
Address:______________________________________________________________
City:_______________________State___________________Zip_________________
Phone Numbers: day_____________ evening_____________cell__________________
Email:________________________________________________________________
Names and emails of people that may pick up for you:_________________________________________________________________
Please choose only one:
Tuesday at Phoenix Hill FM (3:30 to 6:30 pm)-----------------------------________
or
Thursday at Harvey Browne Presbyterian Church 4:00 to 6:00 p.m.--------________
or
Saturday at Radcliff Farmers Market (8 to noon)---------------------------________
Full share (2 adults/2 children approx.); Half share (1 adult, 1 child approx.) just an estimate; it depends on how well your family loves veggies and fruits :)
Both sessions 2012 (spring/fall, 20 weeks) Full share: -----------------__ $675.00________
" " " " " " " " Half share: -----------------__ $400.00________
Spring 2012 only.(10 wks)........................ Full share: -----------------__$362.50________
Spring 2012 only.(10 wks)........................ Half share: -----------------__$212.50________
Fall 2012 only.(10 wks)............................ Full share: -------------- avail June 2012
Fall 2012 only.(10 wks)............................ Half share: --------------avail June 2012
Payment plans accepted with a deposit of $50 to $100 to hold spot. Remainder must be paid by end March. Please talk to us if you need this option. Sorry, no payment plan accepted on egg shares.
10 weeks, 1 dozen per week, Egg Share (CSA members only) during CSA weeks:
XLarge - $37.50________
Jumbo - $42.50________
egg prices: XL $4.00 and Jumbo $4.50 effective January 1, 2012, if purchased one dozen at a time.
Please copy and print this page and mail completed form along with payment to:
Misty Meadows Farm
PO Box 89
Payneville KY 40157
revised 02-08-12
