CSA SIGN UP!

NEW MEMBER 2017 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 - 18 weeks *
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 download a contract. you must submit a completed contract along with your payment to secure your place in the program.

thank you!

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

Current 2016 CSA Renewing members CLICK HERE TO RENEW.

CSA APPLICATION PROCESS

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


FULL/CLOSED LOCATIONS

Spots may open up, so contact us to join our waiting list!

Rockville Centre - Pine Street
Setauket - Galleon Lane
Wantagh - Elm Street
Williston Park - Capitol Avenue