CSA SIGN UP!

2019 CSA APPLICATION - LONG ISLAND ONLY


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 - CONVENTIONALLY GROWN - 14 weeks *
PEACHES, APPLES & PEARS - This Briermere Farm Fruit Share is Conventionally Grown and may be treated with synthetic pesticides.
PICK-UP LOCATION SELECTION
Please choose from one of the pick-up sites listed below. *
If a pick-up location is not listed below, then it is FULL and CLOSED. To be added to our waiting list, please e-mail us at info@goldenearthworm.com
PAYMENT & CONTRACT
After submitting this form, you will be prompted to make your payment. Please remember that your spot in the program is not secure until we receive payment. THANK YOU KINDLY! - Your Farmers

THIS APPLICATION FORM IS FOR MEMBERS AT OUR LONG ISLAND LOCATIONS. QUEENS MEMBERS SHOULD CONTACT THEIR CORE GROUP TO JOIN.

CSA APPLICATION PROCESS

Step 1 : Complete Online Application
Step 2 : Make Payment by following the link on the next page to pay by Check or Credit Card online.

SOLD OUT LOCATIONS

Cold Spring Harbor - Fish Hatchery
Floral Park - Plainfield Avenue
Great Neck - Cedar Drive
Hicksville - Crescent Street
Huntington - Bay Avenue
Huntington - Temple Beth El
Massapequa - Pennsylvania Avenue
Port Washington - Main Street
Port Jefferson - Myrtle Avenue
Rockville Centre - Hendrickson Avenue
Rockville Centre - North Forest Avenue
Rockville Centre - Pine Street
Rockville Centre - S. Lewis Place
Sayville - Lincoln Avenue
Setauket - Galleon Road
Smithtown - Brooksite Drive
Stony Brook - Christian Avenue
Valley Stream - Salem Road
Wantagh - Elm Place

If your selected pick-up location is sold out, please contact us to be placed on the waiting list. 

Thank you kindly!