2024 CSA Sign-up Form Please enable JavaScript in your browser to complete this form.Membership *New MemberReturning MemberReturning MemberIf your contact information has changed, click this box and update it here.Primary Member Name *FirstLastPrimary Member AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrimary Member Email *Primary Member PhoneSecondary Member NameFirstLastSecondary Member AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSecondary Member EmailSecondary Member PhoneShare Type *Full Season Share20-Week Share10-Week ShareFull Season Shares – Choose your size and priceSmall Share ($682-$898)Medium Share ($986-$1392)Large Share ($1667-$2320)Sliding Scale Pricing for Vegetable Shares – We price our shares using a range of prices for each share. You choose the price you pay for your share within that range. See Sliding Scale Pricing.20-Week Season Shares – Choose your size and priceSmall Share ($490-$690)Medium Share ($690-$1080)Large Share ($1190-$1690)Sliding Scale Pricing for Vegetable Shares – We price our shares using a range of prices for each share. You choose the price you pay for your share within that range. See Sliding Scale Pricing.10-Week Season Shares – Choose your size and priceSmall Share ($255-$350)Medium Share ($350-$540)Large Share ($615-$860)Sliding Scale Pricing for Vegetable Shares – We price our shares using a range of prices for each share. You choose the price you pay for your share within that range. See Sliding Scale Pricing.Indicate the amount you will pay for selected share *Additional Shares (please select all that apply)Herb Full ShareHerb 10-Week ShareEgg ShareNumber of Full Herb Shares @ $45/share1234Number of 10-Week Herb Shares @ $22.50/share1234Egg Share Full SeasonFull Season 1/2 dozen per week ($3.35/half dozen; $97.15/season)Full Season 1 dozen per week ($6.35/dozen; $184.15/season)Egg Share 20 Week20 week 1/2 dozen per week ($3.40/half dozen; $68/season)20 week 1 dozen per week ($6.45/dozen; $129/season)Egg Share 10 Week10 week 1/2 dozen per week ($3.40/half dozen; $34/season)10 week 1 dozen per week ($6.45/week; $64.50/season)Number of Egg Shares1234Working ShareCheck here to sign up for a working share.Your discount will be applied to your bill. See Working Shares. Subtotal for selections above *Payment Option (choose one) *Payment in full by cash or check (deduct $15)Pay in full online4 payments (1st due at sign-up, then 6/1, 8/1, 10/1)7 payments (1st due at sign-up, then monthly 5/1-10/1)For those of you who like to do your own math, click here for a worksheet to determine your payment amount/s. For those that don’t want to do the math, no problem. Our bookkeeper will do it for you and send you an invoice shortly. 4 Payment Plan: Divide total above by 4 (payments due on 4/1, 6/1, 8/1, and 10/1) 7 Payment Plan: Divide total above by 7 (monthly payments from 4/1 until 10/1) 4 Payment Plan: 30% of Total above is due at sign-up. Divide remaining balance by 3 (payments due on 6/1, 8/1, and 10/1) 7 Payment Plan: 30% due at sign-up. Divide remaining balance by 6 (monthly payments due from 5/1 – 10/1) Neighbors Help Neighbors FundCheck here if you wish to be considered for a need-based discount on your share. More Info HereDelivery Site (choose one) *Saturdays – Roanoke at Roanoke Natural Foods Co-opSaturdays – Salem at a residence on Taylor Ave.Saturdays – Floyd at Harvest Moon Food StoreSaturdays – 7 Springs FarmTuesdays – Roanoke at Roanoke Natural Foods Co-opTuesdays – Roanoke at Crystal Spring Grocery Co.Tuesdays – 7 Springs FarmWeekly Note (choose one) *Email OnlyEmail & Paper note in bagHow did you hear about us?Comments/Special InstructionsFarm Policy *By submitting this form I agree to the Farm Policy.In becoming a member of Seven Springs CSA: I understand that I am investing in farmland conservation, supporting local food production, and sharing in this farm’s harvest. I understand that I am securing a market for the farmer, and agree to share in the bounty and loss of the season. I agree to make my payments on time and in full as scheduled. I agree to keep my membership contact information up to date. I agree that it is my responsibility to pick up my weekly distribution of food at the designated site and time. Failure to do so is not the responsibility of the CSA. I agree to read all communications from the farm including email, and paper notices (bag notes) sent out weekly with the food. I agree to fulfill all delivery and/or farm work commitments I have made. When you submit your form, you will receive a confirmation email that we received your order. Shortly after, bookkeeper Kim Schwenk will email an invoice with your total and payment instructions. It will include a link for you to pay online. For mailed payments, use CSA PO Box 320 Floyd VA 24091 Date *Submit
