CSA Application

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1780 Farm CSA Applications
This application is for CSA reservations. You may pay for your share by check (preferred) or PayPal. If you choose to pay via PayPal, please make note of your total CSA payment and we will contact you when we begin accepting online payments.

** Please deduct $50.00 from your membership fee if you pay before March 30, 2015 **
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* Indicates required question
First name *
Your answer
Last name *
Your answer
Email address *
Your answer
Zip code *
Your answer
Type of share *
Descriptions below
Required
Do you want delivery? *
Payment method *
Checks can be mailed to 89 Winchester Road, Chesterfield, NH 03443
If you chose a blueberry share, how many pounds would you like to pay for?
Your answer
Interested in a Thanksgiving turkey or duck?
$50 deposit required, birds take 6 months to mature
Clear selection
Interested in a flock of chickens?
Please see details below
Clear selection
Interested in beef or lamb?
If yes, please state your preferences. If no, leave blank.
Your answer
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