| CSA SUBSCRIPTION FORM |
 |
 |
 |
 |
| 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 $525 in full or $262.50 now and then the remanining $262.50 by 4/15/10 HALF SHARE is $288 in full or $144 now and then $144 by 4/15/10 |
| 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 |
| Check |
| ATTENTION!!! The 2010 season sign up is currently OPEN!!!! This is first come status only once we are Full you will be placed on a waiting list for the 2011 season. Thank You |
