www.dharmaridgefarm.com

2010 C.S.A. Subscription Form

name ____________________________________________
address __________________________________________
           __________________________________________
           __________________________________________

phone ___________________________________________
email ____________________________________________
How many people will be eating from your share?   Children ____   Adults ____
What size share would you like?   Small ____   Full ____
Pick Up Site:
____ Uptown Port Townsend
____ At the Farm
____ Port Ludlow Bay Club
____ Port Ludlow Beach Club
Please make your check out to "Dharma Ridge Farm"

Amount Enclosed:
____ $300 paid in full
____ $450 paid in full
I/We would like to subscribe to the 2010 Dharma Ridge Farm C.S.A. program.

I/We understand that availability and schedule of crops is dependent on seasonal
conditions.
signed ____________________________________________________
date _________________

Please Mail to: