CSA Cost
Purchase CSA share online, by phone, at our store, or mail or drop off a check.
$825 ($33/week)
$775 HPF Pick-up

Heritage Prairie Farm CSA 2010 Signup Form
Please copy and email the signup information to info@hpmfarm.com or print this page and bring the information to the Farm or Green City Market.

□ Please check if you have an exisiting Heritage Prairie Farm membership. Existing members take 5% off payment.

My choice for pickup is (check one):
□ Heritage Prairie Farm, Elburn
□ Bespoke Cuisine,1358 W Randolph St, Chicago
□ Chicago Green City Market, Lincoln Park
□ Now We're Cookin', 1601 Payne Street, Unit C, Evanston
□ Chopping Block, 4747 N Lincoln, Chicago
□ City Provisions, 1820 West Wilson Avenue, Chicago

Enclosed is my payment (check one):
□ $825 ($33/week)                      □ $775 (HPF Pick-up)

Please check how payment will be made (check one):
□ Send check to Heritage Prairie Farm, 2N308 Brundige Road, Elburn, IL 60119
□ Dropped off payment at Farm, Chicago Location or Chicago Green City Market
□ Credit card payment made online or over the phone, 630-443-8253

I am interested in volunteer work opportunities at the farm on:     □ Weekdays  □ Saturdays

□ I understand that Heritage Prairie farmers will do their best to offer a wide variety of fresh, organic and chemical free produce. I understand there is a certain risk involved in farming, and although it is a rare occurrence, crop failure can occur.

________________________________________________________
Print Name

________________________________________________________
Address

________________________________________________________
City, State, Zip

________________________________________________________
Email Address

________________________________________________________
Phone Number(s)


Shareholder’s Signature _________________________ Date ___________________