Please print and send this completed form to: Farm Direct Co-op, P.O. Box 1146, Marblehead, MA 01945
Please provide the following contact information:
First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
E-mail
I wish to receive the newsletter via email. I wish to be reminded weekly of my pick up via e-mail. (WE DO NOT SELL OUR LIST)
Check the boxes that apply, add up the total!
MEMBERSHIP FEE
$ 50
Sturdy FDC tote
$ 5
Organic vegetables - single
$180
Organic vegetables - family
$300
Non-organic (IPM) fruit -single
$130
Non-organic (IPM) fruit - family
$190
Organic herb
$ 40
Organic/local cheese
$ 75
Home delivery every week
Extended season (November!)
$ 65
Winter Share (December!)
Donation towards scholarship fund $5 $10 $25
Other ____________
(any amount helps!)
TOTAL DUE:
Preferred pick-up site: Marblehead Salem Melrose
My preference for volunteer help is:
Depot work Serve on the Board of Directors Organizing a field trip or event I have an extra fridge to store cheese
Writing a newsletter article Fold and mail newsletter Delivering shares Depot improvements Other
Please enclose a minimum deposit of $100, check payable to Farm Direct Co-op. Half of balance due by June 30, remainder due by August 31. Payment for any goods or services purchased after September 30 are due when order is placed.
We will happily arrange a payment schedule that works for you - call 1-877-332-3276. (1-877-FDC-FARM)
I was referred by:
Please send my friend a brochure:
Name:
Address: