2019 CSA SIGN UP Click here to download our CSA brochure. 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 What type of share would you like?*If you are in need of financial support, email us firstname.lastname@example.org.Full Share - $650.00Invidual Share - $450.00Salad Share - $200Pro-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 $108.00NoDo you want a Certified Organic Chicken Share?$50 deposit/ $5.75 lb finished5 birds10 birdsNoDo you want a Wally's Place Bread Share?18 weeks $100YesNoDo you want off-farm delivery?*YesNoWhere should your CSA be delivered?Northwest Medical Center, St. AlbansRichford/NMCUVM Medical CenterFort Ethan Allen, ColchesterSt. Alban's City HallOtherWhat 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.