2019 CSA SIGN UP ORDER FORM

2019 LOTFOTL CSA

For more details about our CSA programs you can visit our CHOICE CSA and CSA PROGRAM tabs on the top menu bar.

2019 CSA Registration Form.

Name *
First
Last
Email *
This is where your confirmation email, payment directions, and newsletters will be sent, REGARDLESS OF WHATEVER EMAIL IS ASSOCIATED WITH YOUR LOTFOTL ACCOUNT.
Phone *
Address (If you choose a home delivery program this is where the food will be delivered) *
Address Line 1
Address Line 2
City
State
Zip Code
What CSA program would you like to sign up for? *
I understand that due to the nature of this program, where members get to choose what and how many items they need for the week, I must register ALL household members in the program. Registering 1 person in a multiperson household would compromise both the farm and the program. *
YES, I understand that I must register All household members
Number of FULL SPECTRUM Senior Adults in your family (age 65 and up). Include yourself if applicable (FS) (Single Payment) *
Number of FULL SPECTRUM Adults in your family (ages 18 to 64). Include yourself if applicable (FS) (Single Payments) *
Number of FULL SPECTRUM Children in your family (ages 11-17). (FS) (Single Payments) *
Number of FULL SPECTRUM Children in your family (ages 5-10). (FS) (Single Payments) *
Number of MEATLESS Senior Adults in your family (age 65 and up). Include yourself if applicable (NM) (Single Payments) *
Number of MEATLESS Adults in your family (ages 18 to 64). Include yourself if applicable (NM) (Single Payments) *
Number of MEATLESS Children in your family (ages 11-17). (NM) (Price is based on six monthly payments) (Single Payments) *
Number of MEATLESS Children in your family (ages 5-10). (NM) (Single Payments) *
Number of PRODUCE ONLY Senior Adults in your family (age 65 and up). Include yourself if applicable (P) (Single Payments)
Number of PRODUCE ONLY Adults in your family (ages 18 to 64). Include yourself if applicable (P) (Single Payments) *
Number of PRODUCE ONLY Children in your family (ages 11-17). (P) (Single Payments) *
Number of PRODUCE ONLY Children in your family (ages 5-10). (P) (Single Payments) *
Which CHOICE dropsite will you be picking up at? Items will be chosen directly from our delivery vehicle. It is like a farmers market on wheels. *
Which dropsite will you be picking up at? Items are prepacked and ready to go. *
Weekly Market Produce (6-7 items) (Single Payments) *
Prepacked traditional style CSA box (Single Payments) *
This box is prepacked and contents are chosen by the farmer. You get to be surprised each week when you open the box.
Home Delivery CHOICE MONTHLY MEAT (3 MONTHS) (Single Payments) *
You choose $100 worth of meat each month. $5/month goes to a delivery fee.
Which HOME DELIVERY program would you like to choose? *
Number of FULL SPECTRUM Senior Adults in your family (age 65 and up). Include yourself if applicable (FS) (HD) (Single Payments) *
Number of FULL SPECTRUM Adults in your family (ages 18 to 64). Include yourself if applicable (FS) (HD) (Single Payments) *
Number of FULL SPECTRUM Children in your family (ages 11-17). (FS) (HD) (Single Payments) *
Number of FULL SPECTRUM Children in your family (ages 5-10). (FS) (HD) (Single Payments) *
Number of MEATLESS Senior Adults in your family (age 65 and up). Include yourself if applicable (NM) (HD) (Single Payments) *
Number of MEATLESS Adults in your family (ages 18 to 64). Include yourself if applicable (NM) (HD) (Single Payments) *
Number of MEATLESS Children in your family (ages 11-17). (NM) (HD) (Single Payments) *
Number of MEATLESS Children in your family (ages 5-10). (NM) (HD) (Single Payments) *
Number of PRODUCE ONLY Senior Adults in your family (age 65 and up). Include yourself if applicable (P) (HD) (Single Payments) *
Number of PRODUCE ONLY Adults in your family (ages 18 to 64). Include yourself if applicable (P) (HD) (Single Payments) *
Number of PRODUCE ONLY Children in your family (ages 11-17). (P) (HD) (Single Payments) *
Number of PRODUCE ONLY Children in your family (ages 5-10). (P) (HD) (Single Payments) *
Home Delivery Premium (Single Payments) *
The home delivery package requires an additional delivery fee of $7.70/wk. A total of $200 for the season.
What home delivery day works best? *
HOLIDAY TURKEY ADD ON $4.75/lb - Delivered mid November - DEPOSIT is added to todays total and the balance due is invoiced in November *
PRICE IS $4.75/LB, birds are raised by Green Fire Farm in Monticello, WI. Birds are pastured and fed 100% certified organic feed. Birds are delivered to the pick up site that you use for your CSA.
CHOICE: I understand that I will be invoiced for the total amount due via EMAIL, and I can choose to pay all at once with check or credit card, or pay a $450 deposit and schedule 6 monthly payments. *
Yes, I will be sending a check for the full amount
Yes, I will send a deposit check dated today for $450, in addition to 6 additional post dated checks to be cashed one per month starting in May-October. (see payment estimation directions below)
Yes, I will be paying all at once with my credit/debit card
Yes, I will be setting up AUTOMATED monthly payments (see payment estimation directions below)
*****To estimate your payment amount, take the total amount due minus $450 deposit divided by 6 monthly payments
SATURDAY MARKET: I understand that I will be invoiced for the total amount due via EMAIL, and I can choose to pay all at once with check or credit card, or pay a $150 deposit and schedule 5 automated monthly payments. *
Yes, I will be sending a check for the full amount
Yes, I will send a deposit check dated today for $150, in addition to 5 additional post dated checks to be cashed one per month starting in June -October. (see payment estimation directions below)
Yes, I will be paying all at once with my credit/debit card
Yes, I will be setting up AUTOMATED monthly payments (see payment estimation directions below)
*****To estimate your payment amount, take the total amount due minus $150 deposit divided by 5 monthly payments
BOX PROGRAM : I understand that I will be invoiced for the total amount due via EMAIL, and I can choose to pay all at once with check or credit card, or pay a $150 deposit and schedule 5 automated monthly payments. *
Yes, I will be sending a check for the full amount
Yes, I will send a deposit check dated today for $150, in addition to 5 additional post dated checks to be cashed one per month starting in June -October. (see payment estimation directions below)
Yes, I will be paying all at once with my credit/debit card
Yes, I will be setting up AUTOMATED monthly payments (see payment estimation directions below)
*****To estimate your payment amount, take the total amount due minus $150 deposit divided by 5 monthly payments
MEAT ONLY: I understand that I will be invoiced for the total amount due via EMAIL, and I can choose to pay all at once with check or credit card, or pay a $125 deposit and schedule 3 monthly payments. *
Yes, I will be sending a check for the full amount
Yes, I will send a deposit check dated today for $125, in addition to 3 additional post dated checks to be cashed one per month during the 3 months that you will receive delivery. (see payment estimation directions below)
Yes, I will be paying all at once with my credit card
Yes, I will be setting up AUTOMATED monthly payments (see payment estimation directions below)
*****To estimate your payment amount, take the total amount due minus $125deposit divided by 3 monthly payments
I have read and agree to the LotfotL terms and conditions (view link below) *
Yes. I read the conditions and took note of everything including the cancelation policy.
Total
$ 0.00
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Terms and Conditions

Make sure to click on Submit.