2017 CSA Shares Pledge Form
NEW IN 2017! Sign up online: https://tinyurl.com/UCSC-CSA
Center for Agroecology &
Sustainable Food Systems
831-459-3240 | [email protected]
In becoming a member of the UCSC Farm CSA, I understand the following:
• I am making a financial commitment for the 2017 farm season. As the designated primary
shareholder, I understand that my share payment is non-refundable.
• I recognize that due to the inherent risks of farming, there are no guarantees on the exact
amount of produce that I will receive.
• Th
at my share comes from an educational farm and that apprenticing farmers are
producing my food.
• I understand and accept this commitment and assume responsibility to contact the staff if
there are any questions or concerns.
EARLY BIRD DISCOUNT:
Sign up by May 1 to
receive 5% off the full
season rate of $560
(total w/discount = $532)
To confirm membership in the 2017 CSA program, sign up online, or send payment and a signed pledge form to the address below.ig
Signature_________________________________________________________________ Date:
Primary
Shareholder:
CoShareholder:
Primary
Address:
Zip:
Primary
Phone:
Cell or
Work #:
Email:
Co-share
Email:
Co-share
Phone: ___________________________________________
Share
and Payment Options:
FULL SEASON: 22 Weeks
q Payment in full:
q Two checks:
today’s date post-dated June 1
q Four checks:
today’s date
post-dated June 1
post-dated July 1
post-dated Aug 1
$
(Tues 6/6, thru Fri 11/3)
560
280
$
280
$
140
$
140
$
140
$
140
$
FLOWER SHARE: (5% discount for 20 week share)
20 Weeks (Tues 6/20, thru Fri 11/3)
q payment in full: $190
10 Weeks, early (Tues 6/20, thru Fri 8/25)
q payment in full: $100
10 Weeks, late (Tues 8/29, thru Fri 11/3)
q payment in full: $100
Note: to prorate a full or late season share, multiply $25.50 by the remaining number
of weeks in the 22-week season.
For example, if you begin on July 19: 16 wks remaining x 25.50 = $408.00
LATE SEASON: 11 Weeks (Tues 8/22, thru Fri, 11/3)
q Payment in full: $280
q Two checks:
today’s date
post-dated Sept 1
140
140
$
$
Pick-up Site Options - choose one:
q
q
Tuesdays on the UCSC Farm (noon-6:00 p.m.)
Fridays on the UCSC Farm (noon-6:00 p.m.)
WESTSIDE PICKUP SITE:
q
Westside - Tuesday only (2:30-5:15 p.m.)
estside Farm & Feed
W
817 Swift St., Santa Cruz 95060
Office Use Only: Date rec’d: ________ Payment amount:______________
Fill out and sign this pledge form, and mail
with payment to:
CASFS / UCSC Farm
1156 High Street
Santa Cruz, CA 95064
Attn: CSA
Please make checks payable to “UC Regents”
Make a donation to support low-income shares!
We gratefully accept donations to support low-income
shares. Donations are tax deductible.
If you would like to donate, please include with your pledge
form and payment, indicating the amount below:
q $25 q $50 q $100 q $280 (full share)
I would like to donate $_______ to a low-income share.