Purchase CSA Share with Check

This form* is for members who decide to pay for their share (whole or in installments) with a check/checks mailed to:

Full Moon Farm, 2083 Gilman Rd, Hinesburg, VT 05461.

Full payment must be included with the initial registration. The idea behind a CSA is that the farm has the money up-front to help pay for necessary items before the income of the farm season starts coming in. Please pay in full if you can. However, if you need to pay in installments, a minimum deposit of $195 is required along with all other payments.

Please post-date each additional check for the 1st of each month you choose (i.e. May 1 , June 1, July 1). All members must be paid in full by July 1, 2024.

Please make sure the first and last name of the primary contact person is clearly written on the check. If this is not the case, please be sure to include a piece of paper clearly designating the first and last name of the intended primary contact. We want to make sure your credit is allocated to the proper share.

* If you want to fill out and mail a paper version of this form and send payment, please reach us at csa@fullmoonfarminc.com to email a PDF version.

Full Moon Farm
2024 Summer Registration Form

Primary Contact First Name

Primary Contact Last Name

Primary Contact Email Address

Primary Contact Phone #

(###)

###

####

Secondary Contact First Name

Secondary Contact Last Name

Secondary Contact Email Address

If you want someone else to receive the emails about pick-ups, you must list them here.

Secondary Contact Phone

(###)

###

####

Other Names and emails Authorized to use account:

Share Sizes

MINI: Pay $395 for $416 credit on your farmshare card. (A 5% bonus!)

SMALL: Pay $595 for $635 credit on your farmshare card. (A 7% bonus!)

MEDIUM: Pay $895 for $985 credit on your farmshare card. (A 10% bonus!)

LARGE: Pay $1195 for $1327 credit on your farmshare card. (An 11% bonus!)

EXTRA LARGE: Pay $1495 for $1675 credit on your farmshare card. (A 12% bonus!)

TOTAL

Please fill in the price of the share you are purchasing below: Mini: $395 | Small: $595 | Medium: $895 | Large: $1195 | Extra Large: $1495

$

Amount of Initial Deposit - if applicable

Please pay in full if you can. If you need to pay in installments, please include a deposit of $195.00 plus all other checks, post-dated for the 1st of each month you choose (i.e. May 1 , June 1, July 1.) All members must be paid in full by July 1, 2021. Please write the amount of each check on the line below.

E-Signature

In submitting this form, I understand that this is a financial commitment and that there is no specific guarantee regarding the amount or selection of product that will be available at any pick-up or market. I understand that Full Moon Farm will make every effort to provide a broad and generous selection of fresh organic produce, flowers, chicken, pork, eggs, and CBD products, and that I can use my credit at any of their locations, in any increments, on any products, within the designated time-frame. Failure to use up my credit will result in the rest being donated to Full Moon Farm's Buy Food Not Crap Program which helps feed healthy organic food to hungry folks. I also understand that the format and abilities of our CSA distribution may change as necessitated by the constraints of the coronavirus.

Low Income Share Donation

NOFAVT offers a farmshare program to help lower-income families access fresh food. Through this program, the family pays 50%, NOFAVT covers 25% and individual farms, like ours, cover 25%. If you would like to contribute to this great program, please include a separate check out NOFA-VT and include it with your payment mailed to Full Moon Farm. By doing so, your donation will be eligible for a tax deduction.

CSA Registration Form

Purchase CSA Share with Check

Full Moon Farm 2024 Summer Registration Form

Low Income Share Donation

Full Moon Farm

Full Moon Farm
2024 Summer Registration Form