| First Name * | |
| Last Name * | |
| Email * | |
| Address * | |
| City * | |
| ZIP * | |
| Phone * | |
| I want to have a: * |
family size box ($23)
regular size box ($18)
|
| Pick up, Drop off or Delivery* |
I want to pick up my box.
I want to be a drop off site (please write location below).
I want to have delivery.
|
| Payment Plan* |
I will prepay for the whole year.
I will prepay in three months installments.
I will prepay monthly.
|
| Additional Message: |
|
| * Are required fields |
| With submitting this form, I agree to pay in full by the stated payment dates. I understand that the harvest projections are estimates which may vary within the season.
|
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