Needle-Lane Farms Lenawee County CSA  Membership Form for 2010

Print form, fill out, Enclose Payment, and return to: Needle-Lane Farms, 6376 Tipton Hwy, Tipton, MI 49287
For information :
e-mail: needlelane@tc3net.com or phone: 517-263-5912

Name_____________________________________

Phone______________________________

Address_________________________________

Cell Phone (Optional)___________________

City/Zip___________________________________

E-Mail______________________________

Share Selection

_____  $620     Full Season Family Share May-October (20 weeks)

_____  $350     Full Season Single Share May-October (20 weeks)

_____  $424     Summer Season Family Share July-September (12 weeks)

_____  $262     Summer Season Single Share  July-September (12 weeks)

_____  $200     Cut Flower Share  June-September (16 weeks)

Pick-Up Options (Please Check One)

____  Tuesday 12pm-6pm  Needle-Lane Farms

____   Saturday  9am-1pm  Tecumseh Farmers Market

____   Saturday  8am-Noon  Adrian Farmers Market

Payment Selection (Please Check One)

_____   Single Payment - Enclose one check for the total amount. (This is best for us if you can swing it.)

_____   2 Installments - Enclose two checks, one with today's date, one dated for deposit on June 1, 2010  
            (This saves us time and money.)

_____  Pre-Season Deposit - Enclose a $50 non-refundable deposit to hold your membership.   
           Send the balance or half the balance by April 15. (Paid in full by June 1, 2010)

______ TOTAL DUE

_____  AMOUNT ENCLOSED  

Signature___________________________________

Written receipt of your membership will be acknowledged by mail. This agreement represents a season long contract. Needle-Lane Farms will transfer your share to an individual of your choice if you must terminate your membership

Back to Needle-Lane Farms Home