EmailMe Form - Bush Prairie Farm 2022 Subscription Sign-Up Form

Name

First Last

Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Select Regular or Lite Subscription

Regular, Serves 3-4 adults

Lite, Serves 2-3 adults

A regular share which feeds 2-3 adults or small family is $585 for the 16-week season. The lite share feeds 1-2 adults at $465.

Select payment option

Regular-$560 if paid in full by May 15, 2021

Regular-$150 deposit + 3 monthly payments@$145 each

Lite - $445 if paid in full by May 15, 2021

Lite - $105 deposit + 3 monthly payments @$120 each

To confirm your subscription, we request a deposit of $150 for the regular share or $105 for the lite share. The deposit is included in the total cost of the share. The remainder is split into three equal payments due the first of the month for June, July, and August. There is a $25 discount on a regular share and a $20 discount on a lite share for payment in full by May 15, 2021. Send check or use our PayPal account at https://paypal.me/Bushprairiefarm?locale.x=en_US.

Select day to receive share

Monday - Deliveries or Pick-up

Thursday - Pick-up Only

Pick-up is at the farm between 5 and 7 pm.
If you live in Bridlewood, Deschutes Ridge, Deschutes Heights, Parkridge, or Bush Prairie, we deliver ON MONDAYS ONLY between 3 and 6 pm.

Agreement Below Name *

First Last

If you are out of town, please make arrangements for someone else to pick your share up OR drop us an email and we will take it to the food bank.

I have read and understand the membership payment and delivery day details above. I also understand that availability of crops may vary with seasonal conditions

	Like	Don't Send	Don't Know
Beans, green	1	2	3
Beets	1	2	3
Bok Choy	1	2	3
Broccoli	1	2	3
Cabbage	1	2	3
Carrots	1	2	3
Chard	1	2	3
Cilantro	1	2	3
Cucumber	1	2	3
Eggplant	1	2	3
Garlic	1	2	3
Green onions	1	2	3
Lettuce	1	2	3
Kale	1	2	3
Onions, dry	1	2	3
Parsley	1	2	3
Peas, sugar/snow	1	2	3
Peppers, sweet	1	2	3
Peppers, spicy/mild	1	2	3
Peppers, hot	1	2	3
Potatoes	1	2	3
Sweet Potatoes	1	2	3
Tomatillos	1	2	3
Tomatoes	1	2	3
Winter squash	1	2	3
Zucchini/summer squash	1	2	3

Comments or Questions

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