2022 CSA Sign Up – Blue Heron Farm VT

Name*

First Last

Email*

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What type of CSA share would you like?*

Full Share - $650
Individual Share - $450
Pro rated - Summer Resident
Salad Share - $200, Farm Pickup Only
Financially Supported Share/Pay What You Can
Honor System Sliding Scale

What type of Financially Supported Share are you interested in?

Full Share
Individual Share

We rely on the honor system to offer our CSA shares at a reduced cost.

If you are in need of financial assistance beyond the prices below, please fill out this form: https://www.blueheronfarmvt.com/application-for-financially-supported-csa-share

What type of pro-rated share would you like?

Full
Individual

Summer Resident - Full

$40 per week, enter number of weeks.

Price: $40.00

Summer Resident - Individual

$25 per week, enter number of weeks.

Price: $25.00

For those who would like to access our honor system sliding scale:

Full Share $575
Full Share $600
Individual Share $375
Individual Share $400

Do you want a Certified Organic Egg Share?

1 dozen per week $108
Half dozen per week $54
No

Do you want a Certified Organic Chicken Share?

$50 deposit, $5.95 per lb

5 birds
10 birds
No

Do you want a Wally's Place Bread Share?

18 weeks $118, THURSDAY DELIVERY ONLY

Yes - 18 weeks
No

Do you want a Perky Planet Coffee Share?

1 lb of coffee each week for 18 weeks, Whole Bean or Ground, $252. ($14 per week)

Yes - Whole Bean
Yes - Ground
No

Do you want off-farm delivery?*

$50 delivery fee

Yes
No

Where should your CSA be delivered?*

UVM Medical Center
Northwestern Medical Center, St. Albans
Rail City Market - St. Albans
Milton - Maplewood Ave
Other

Enter Other Delivery Location:

What is your preferred day for on-farm pickup?*

CSA pickup is at the farm in Grand Isle

Monday 4-6:30pm
Thursday 4-6:30pm
I'm flexible

Will you be participating in a working share?

Deducts $50.00 from share cost – 5 hrs of work per month

Yes
No

Would you like to make a contribution to the VT Farm Share For Blue Heron Supported Shares?

Yes
No

Enter Contribution Amount*

Would you like to make a contribution to Food For Thought produce - Summer lunch program?

Yes
No

Enter Contribution Amount*

Please check that you read all the statements below before continuing to payment.*

I am sharing in the reward & risk of my CSA membership as described on this brochure.
I understand that I must pick up my CSA share on the appropriate dates & times or my share may be donated.
I understand that this CSA has an honor system sliding scale and will respect it.
I understand that the farm will send important communications to me via email.

Processing Fee

Price:

Total

$0.00

Email

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