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DUTCH KILLS CSA


CSA MEMBERSHIP APPLICATION FOR DUTCH KILLS, QUEENS PICK-UP


DUTCH KILLS 2017 CSA INFORMATION

Please read these details carefully before completing the application form below.

Pick-up Location:
3710 36th Avenue
Long Island City, NY 11101

Pick-up Times: TUESDAYS between 4:30pm and 7:45pm Prompt
Anything not picked up by 7:45pm will be donated to a food pantry.
 
Volunteer Requirements: All members are required to volunteer for 6 hours a season, in 1-1/2 to 2 hour shifts.  Volunteer shifts may include unloading the truck, overseeing pick-up, set-up and/or clean-up. 

YOUR INFORMATION
Phone *
Phone
Address *
Address
SPLIT/SHARED MEMBERSHIPS
Are you splitting the share with someone?
Share Partner's Name
Share Partner's Name
CSA SHARE SELECTION
VEGETABLE SHARE - CERTIFIED ORGANIC - 25 weeks *
Certified Organic produce grown exclusively on our farm. Runs for 25 weeks, June through November.
ADD-ON OPTIONS
BRIERMERE FARM FRUIT SHARE - NON-ORGANIC *
$30 ADMINISTRATIVE FEE
Please note that all members are required to pay a $30 adminstrative fee that covers program costs and dues to just food's csa network. $5 is contributed to Just Food.
VOLUNTEER REQUIREMENT
We are a volunteer-run organization and as such, we require all members to fulfill 6 hours of volunteer time overseeing the distribution, which may include set-up and clean-up. The volunteer shifts run from 1.5-2 hours.
PAYMENT & CONTRACT
We accept check, money order or credit card payments. You have the option of making your payment in 1, 2 or 3 installments when paying by check. Details can be found on the contract. (you'll be prompted to download contract after hitting the "submit" button below.)
After submitting this form, you will be prompted to download a contract. you must submit a completed contract along with your payment to secure your place in the program. Alternatively, you may agree to the terms of the contract and pay by credit card by following the online payment link.

thank you!

PLEASE NOTE THAT THIS APPLICATION IS FOR MEMBERS PICKING UP AT DUTCH KILLS CSA ONLY.

DUTCH KILLS CSA
3710 36th Avenue
Long Island City, NY 11101

Phone: 718-825-6029
Website:  http://dutchkillscsa.weebly.com/
E-mail: dutchkillscsa@gmail.com

 

CSA APPLICATION PROCESS

Step 1 : Complete Online Application
Step 2 : Download, Print & Complete Contract
Step 3 : Mail Contract & Payment to the Farm