application
for CSA


Name:______________________________________________________


Address:____________________________________________________

City:___________________________________Phone:_________________

Cell:______________________________Number in household:____________


____  One time.   Non refundable membership fee: $50.00
(if you were a memeber last year
you do not pay this fee again)


Share options:

___ Plan 1: A full share of veggies, fruit, herbs and eggs, delivered to my home  for 22 weeks
beginning M
ay 23, 2012:   $1078

___ Plan 2: A full share of veggies, fruit, herbs delivered to my  home for 22 weeks
beginning M
ay 23, 2012: $1012 (without eggs)

___Plan 3: A half share , same as plan 1 delivered to my home every other week for 22 weeks
beginning the M
ay 23, 2012 (11 weeks) :$539 (with eggs)

___ Plan 4:  A half share , same as plan 2 delivered to my home every other week for 22
weeks beginning theM
ay 23, 2012 (11 weeks) :$506

Your total payments:
_______  Non-refundable membership fee ( one time only)
( this is for first time members)

_______ Plan1

_______Plan 2

______Plan 3

______ Plan 4

_______ Total:

____ I'll pay in full.

_____ I'll use a payment plan.  ( Enclosed is my one time non refundable membership fee.
Divide the total of your plan by 4 and send one payment each month for 4 months.  All fees
must be paid by M
ay 1, 2012
_____ I need a custom payment plan.  I will enclose my membership fee and a list of dates
and amounts I will pay, knowing I must have  all my share payments  made by M
ay 1, 2012
____
Send checks payable to : Bowen Creek Farm to Bowen Creek Farm, 1030 Bowen Creek Rd.,
Niangua, Mo 65713


Terms and Conditions:
Bowen Creek Farm agrees to provide a cooler of Farm Fresh fruit, produce and herbs each
week, in season, for 22 weeks.  Variety of produce shall be at the discretion of Bowen Creek
Far
m May 23,2012 and end October 17, 2012
Please make arrangements for your produce if you are out of town or on vacation. We cannot
carry over shares to any other time or week.   You can , however, pick that week up at the
farm on a day agreed to by Bowen Creek Farm and the share holder
If you are a returning customer, please disreguard your $50
membership fee and send a deposit of 10% of your plan fee to
hold your place.  The 10% will be subtracted from your total plan
fee.  All fees, unless you are on a payment plan must be paid in
full by May 1, 2012.  Thanks.