| CSA SUBSCRIPTION FORM |
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| Terry Kromer 206 Garr Rd. Easton Pa 18040 610-258-5050 610-703-0850 E-mail: clearspringfarm2@yahoo.com Please complete your personal information below. Please make sure that the curser is located to the far left of the input boxes below where the curser will turn into the I symbol |
| CSA |
| Name: Address: Phone: Work Phone: Cell Phone: Email: Payment: |
| FULL SHARE is $575 in full or $287.50 now and then the remanining $287.50 by 4/15/12 HALF SHARE is $300 in full or $150 now and then $150 by 4/15/12 |
| MC |
| VISA |
| We do accept Mastercard and Visa but do to security reasons we do not take them over the internet. If you wish to use a credit card you may select which type. Hit the submit button and we will contact you. |
| FULL SHARE |
| HALF SHARE |
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| ATTENTION!!! The 2012 season is open for enrollment. The shares are first come for serve so reserve your spot early to ensure your produce for this upcoming season. Thank You |
