HIgh COUNTRY CSA MEMBERSHIP APPLICATION

PLEASE FILL IT OUT IN FULL.

Thank YOU!

About You
Name *
Name
Phone Number *
Phone Number
Address *
Address
CSA OPTIONS
Full Season is 22 weeks total (May 31 – October 25). Summer Season is 9 weeks total (June 14 - August 9). We will also be offering a Fall season share (11 weeks) for those who aren't in town over the summer! We offer three different options for the FULL SEASON: - REGULAR is perfect for 2-4 people. These shares include more produce than the small shares and typically more variety as well. This is the perfect option for a family, shared house or apartment, group of friends, etc. Cost: $560 for the full season (22 weeks). This comes out to about $25/week. - SMALL is perfect for 1-2 people or a larger family that eats out often. Cost: $400 for the full season (22 weeks). This comes out to about $18/week. - STAPLES is the size of a REGULAR share but will include more of the "staple" vegetables: potatoes, tomatoes, lettuce, etc. This is a great option for those who prefer consistency over variety! Cost: $410 for the season (20 weeks). This comes out to about $20/week. We offer one option for the SUMMER SEASON: - REGULAR is perfect for 2-4 people. These shares include more produce than the small shares and typically more variety as well. This is the perfect option for a family, shared house or apartment, group of friends, etc. Cost: $250 for the summer season (9 weeks).
ADD-ONS
Choose your Desired Add-Ons:
PICK-UPS
We will confirm your pick-up location before the season begins. Pick-ups are Wednesday afternoons (unless otherwise noted). Some of our pick-up sites will have a fee (to be paid upfront) to cover gas expenses.
We will send an invoice to each of you (with the total amount due split 50/50). Email us if you want to split your share but don't have someone to split it with and we will try our best to match you up!
PAYMENT METHODS
If unable to pay in full, are you interested in speaking to us about our Cost Share Program?
HCCSA is proud to support a limited number of members in our Cost Share Program. This program, funded by community fundraising and grants, is designed to increase access to high quality, local foods for our low-resource community members. Cost Share members must be approved in advance. Members who qualify are those who are receiving an income-based service, such as EBT/SNAP benefits, WIC participation, or income-based medical services. Funding for this program for 2017 is from the North Carolina Community Foundation, the Village Vision Festival, and generous donations from community members.
DONATIONS
If you would like to make a one-time [tax-deductible] donation to support members of our Cost Share Program, please select your desired donation amount below: