Part Time Produce

2025 test csa form

Primary Adult Member *

First

Last

Email *

This will be used to contact you about changes or updates about your CSA pick-up/delivery and confirmation of delivery for home delivered items.

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

2024 REGULAR SEASON OPTIONS: What CSA program would you like to sign up for? *Level 1 $875Level 2 $1350Level 3 $1850

All credits must be used by the end of the 2025 regular CSA season in October. After credits have been used up for the season, additional orders are simply charged to your card on file. Some restrictions apply.

Would you like to add additional credits? *Nope, but thanks.100 for $100205 for $200510 for $5001025 for $1000

Additional credits that are purchased in advance offer great value. This helps your farmer to better plan the growing season and manage cash flow throughout the season. Thank you.

Please confirm that you understand each program detail. (click all of the boxes) *

• I invest in credits that I will spend on the online FarmMatch Store
• Orders are all placed through FarmMatch.com. I will respond to the action request to join farmmatch
• When I order I must spend a minimum of $40 and cannot go over $250
• If I order meat, I cannot order more than $200 at a time
• I must use all of my credits during this season and lose them if I don't (June - October)
• When I place my order the cost will be estimated and my account will have the exact number of credits deducted after it has been packed and delivered

FarmMatch Account *I have a FarmMatch account set up already because I am a returning CSA memberI need to set up a FarmMatch account

What EMAIL is your FarmMatch account under?

Thank you. This will help to make sure we issue credits to the correct account.

Delivery/Pick-up: *PLEASE CHOOSE ANOTHER OPTION - This location is SOLD OUT and no longer available - Please CONFIRM that you live in our delivery area. https://lotfotl.com/faq/#deliverySaturday pick up at the farm - LotFotL Community FarmSaturday South Shore Farmers MarketSaturday Shorewood - Northwoods building

If your preferred location is marked as SOLD OUT we ask you to choose an alternative location at this time. Thank you.

I understand there is a fixed delivery fee for home delivery. *2025 Regular season home delivery fee $150Deliver my box to my friend's house. Give me the discounted rate. $50Deliver my friend's box to my house. Give me the discounted rate. $50Waive my delivery fee, my box is part of a pre-approved bulk drop at my workplace.

If you are interested in your workplace becoming a bulk dropsite, please have your HR department reach out to us. Bulk sites need 10 members to participate and a way to receive the food.

You are splitting the delivery fee and picking up at a friend's place. What is your friends name?

You are splitting the delivery fee and letting someone pick-up at your place. Who's box are we dropping at your house?

We will process your order when we have received applications from both parties.

When folks share a pick-up location, each family must have their own cooler with their name displayed on the cover so our delivery person knows where to put your food. *

• Yes. We can do this.

We are waiving your delivery fee. What PRE-APPROVED workplace are we dropping your food at?

DELIVERY ADDRESS CONFIRMATION: What address will your food be delivered to? (Especially important if you are splitting the delivery fee with someone or having your box dropped at your workplace) *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Location specific delivery details. We need to know location of your cooler/box, building codes, or directions to enter your building, etc. Remember driver must be able to put food into a container that you leave out. Driver cannot enter your home.

Please confirm that you understand these details about home delivery. *

• Estimated delivery times will be announced when we have created a delivery route with all members (May 2025)
• Delivery drivers must have access to a receiving container (such as a beach cooler) that will safely house your food
• Drivers are not allowed to enter your home
• If driver must enter your building, directions must be given. Please confirm with building management that you are allowed to leave a cooler by your door or in a desitgnated area to receive your food

Optional donation to our food equity fund: Donations will go toward reducing the costs of our food for our customers expressing a financial need. *$0 $10 $20$50$100$250$500

CHOOSE PAYMENT OPTION: We will invoice you. How do you plan to pay?Send a check for the full amount - FARMER PREFERREDSend the $150 deposit check and 5 additional post dated checks - FARMER PREFERREDPay my $150 deposit and then set up automated monthly payments (3.5% fee)Pay the full amount with my credit/debit card (3.5% fee)

Don't worry we will email you an invoice laying out all the details.

I have read and agree to the LotfotL terms and conditions (view link below) *

• Yes

How did you hear about this program? *

Total Amount Due

$0.00

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This program replaces the old style traditional CSA options. Members get to choose 7 items each week. The program allows for pick up on 15 of the 24 weeks that we deliver.

Cost: $300 + $40 deposit.