Sign Up for a CSA Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Are you a returning CSA Member? * Yes No Is this a gift? If you'd like the gift to be shipped to the recipient, please email me. Otherwise, select from the pick-up locations below. Yes No Gift Recipient Name First Name Last Name Pickup Location * Please choose a location to pick up your bi-weekly share this season Osamequin Farm (80 Walnut St, Seekonk, MA) Hawes Fine Foods (107 Hope St, Providence, RI) Select Your Share * if you're interested in combining the herbal and table CSAs, please contact me directly! Full Herbal Share: $275- $350 - pick up bi-weekly Half Herbal Share: $150 - $200 - pick up monthly Full Table CSA: $200 - $300 - pick up bi-weekly Half Table CSA: $110 - $160 - pick up monthly Payment Amount * Please indicate the amount you plan to pay for your share: Need a payment plan? please make a note here if you'd like to discuss payment options Payment Type * Due in full by June 1 (preferred) Check made out to Emily Shapiro (deliver or mail to Osamequin Farm at 83 Walnut St., Seekonk, MA 02771) Venmo @night_garden Check this box if you need information about payment plans Questions or Comments Thank you!