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Hesperides Organica Farm
2014 CSA Application
24 weeks: June 11-November 19, 2014
Last Name: ____________________________________ First Name: _________________________________________
Address: _______________________________________ City: _____________________ State: ____ Zip: ___________
Cell Phone: ______________________ Email: ___________________________________________________________
Additional email(s): ___________________________________________________________________________________
Pickup Locations: Wednesdays
_____ Hawthorne, NJ (Main Location) 27 Utter Ave. 2-7 pm
_____ New Milford, NJ 685 Princeton St. 1-8 pm
_____ Ringwood, NJ 16 Skyline Lakes Drive 1-6 pm
_____ Union City, NJ 1516 Palisade Ave. 6-8 pm (St. John's Church)
_____ Ramsey, NJ 70 E. Main St. 1-6 pm (Baked in a Cup)
_____ Pelham, NY 451 Esplanade 4:30-6:30 pm (Pelham Jewish Center)
_____ Hackensack, NJ 685 Main St. 1-6 pm (Tarts & Flours Bakery)
_____ Other (Minimum number 10)
Payment Options: Please check one.
Hawthorne: 24 weeks at $30 per week
______ One payment: Please enclose a check in the amount of $720 with your application.
______ Two payments: Please enclose a check in the amount of $365. Second payment of $365 is due August 1.
Other Pickup Locations: 24 weeks at $32 per week
______ One payment: Please enclose a check in the amount of $768 with your application.
_____
Two payments: Please enclose a check in the amount of $384. Second payment of $384 is due August 1.
Please mail form and check made payable to Hesperides Organica to:
Hesperides Organica
5 Owl Lane
Warwick, NY 10990
Please Note: If you are on vacation or unable to pick up your share, you may have a friend or relative pick up your share. Otherwise, we will donate
your share that week to a family in need. No refunds will be given for any missed weeks.
Thank you for your continued support. We look forward to a full harvest!
I understand that by signing up for Hesperides Organica Community Supported Agriculture (CSA) I agree to share in the risks of agriculture with the farmers and
understand that is a community supported venture in which there are no guarantees that any specific crop or any specific quantity will be distributed in the CSA boxed
share.
Signed: ___________________________________________________________ Date: ______________________________________________