CSA Subscription Order Form


Thank you for joining our Dog Mountain Farm CSA Program!

CSA Terms of Agreement
I appreciate locally grown produce and want to ensure that it remains available in the Puget Sound area by becoming a shareholder in Dog Mountain Farm Community Supported Agriculture (CSA). I understand that I am not entitled to substitutions or special requests in my weekly delivery and that the farmers, David and Cindy Krepky, will do their best to provide the produce they propose at the times they estimate. However, as a shareholder in both the bounty and the risk, I understand that nature ultimately decides what I will receive and when I will receive it. I understand there are no refunds, although if I can find a replacement I may transfer my share to another party.

Contact Information

            Name 
  Street Address 
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal Code 
      Work or Mobile Phone 
      Home Phone 
          E-mail 
CSA Share Selection
Summer Share 15 weeks (May 31-September 10) $525.00 (check) or $560 (credit card)
Farm pickup
Queen Anne Farmers Market, Thursday 3-7 PM
Phinney Farmers Market, Friday 3-7 PM
Magnolia Farmers Market, Saturday 10 AM-2 PM
Broadway Farmers Market, Sunday 11 AM-3 PM
Fremont Farmers Market, Sunday 10 AM-4 PM
Bellevue, Residence on SE 46th Way, Sunday 
Fall Share 15 weeks (September 12-December 19) $450.00 (check) or $480 (credit card)
Farm pickup
Fremont Farmers Market, Sunday 10 AM-4 PM
Broadway Farmers Market, Sunday 11 AM-3 PM
Bellevue, Residence, Sunday 

Add an Egg Share 15 weeks $90.00 (check) or $95 (credit card)

Summer (May 31-September 10)

Fall (September 12-December 19)

Add a Poultry Meat Share 15 weeks $337.50 (check) or $360 (credit card)

Summer (May 31-September 10)

Fall (September 12-December 19)

 

Payment Preference
Check (Payable to Dog Mountain Farm LLC, PO Box 17, Carnation, WA 98014)
Credit Card (Please call 425.333.0833 or for secure payment go to Localharvest.org)


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Copyright © 2010 Dog Mountain Farm LLC. All rights reserved.
Revised: 03/10/10