2017 CSA Sign up Download the 2017 CSA Brochure 2017 CSA SIGN UP Name* First Last Email* PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Full SharePlease choose what payment you can afford, we have a honor system sliding scale.Select oneFull Share $650.00Full Share $625.00Full Share $575.00Individual SharePlease choose what payment you can afford, we have a honor system sliding scale.Select oneIndividual Share $450.00Individual Share $425.00Individual Share $375.00Do you want a Salad Share?Yes - $200.00NoPro-rated share for summer residents - Full Share $40 per weekQuantity is the number of weeks in share. Price: $40.00 Quantity: Pro-rated share for summer residents - Individual Share $25.00 per weekQuantity is the number of weeks in share. Price: $25.00 Quantity: Do you want a Certified Organic Egg Share?1/2 dozen per week $45.001 dozen per week $100.00NoDo you want a Certified Organic Chicken Share?$50 deposit/ $5.75 lb finished5 birds10 birdsNoDo you want Farm Fresh Milk?$5 per 1/2 gal x 18 weeks = $90 (Farm pick up only)YesNoDo you want a Wally's Place Bread Share?$5.00 x 18 weeks = $90YesNoDo you want off-farm delivery?*YesNoWhere should your CSA be delivered?Northwest Medical Center, St. AlbansUVM Medical CenterFort Ethan Allen, ColchesterOtherWhat other location should your CSA be delivered?Will you be participating in a working share?Deducts $50.00 from share cost – 5 hrs of work per monthYesNoWould you like to make a contribution to the VT Farm Share For Blue Heron Supported Shares?YesNoEnter contribution amount: Would you like to make a contribution to Food For Thought produce - Summer lunch program?YesNoEnter contribution amount: Processing Fee $10.00 Total $0.00 Please check all below before continuing to payment.* I am sharing in the reward & risk of my CSA membership as described by Blue Heron Farm. I understand that I must pick up my CSA share on the appropriate dates & times or my share may be donated. I understand that the farm will send important communications to me via email.