2013 Sauvie Island Organics
Community Farm Agreement

Member contact information

First name

Last name

Street address line 1

Street address line 2

City

State

Zip code

Telephone

Email

New member - please check this box if you are a new member

Please select which share option(s) you would like to purchase for the 2013 season

• Family Share - $920
• Half Share - $500
• Salad Share - $145 (25-weeks)

SE Portland

• 34th & SE Ankeny (Laurelhurst) Tuesday PM Staffed
• 9th & SE Tacoma (Sellwood) Tuesday PM
• Lincoln Street Church (Mt Tabor - 52nd & Lincoln) Tuesday PM

NE Portland

• NE 32nd & Prescott (Concordia/Alameda) Wednesday PM
• Metro Building Tuesday PM
• Portland State Office Building Tuesday PM

SW Portland

• Hillsdale Food Front (6344 SW Capitol Highway) Thursday PM

NW Portland

• 26th & Thurman (Friendly House Community Center) Thursday PM 4:30-6:30pm Staffed
• Ecotrust Building (721 NW 9th) Thursday PM
• Legacy Good Samaritan Medical Center (1015 NW 22nd Ave) Thursday PM
• Portland Development Commission (Employees Only) Tuesday PM

N Portland

• St. Johns Wednesday PM
• Interstate & Ainsworth (Edge Performance Fitness) Wednesday PM

Providence Health & Services

• Providence Portland Medical Center (Employees Only) Wednesday PM
• Providence Office Park (Employees Only) Wednesday PM
• Providence St. Vincent Medical Center (Employees Only) Thursday PM

The Farm

• 13615 NW Howell Park Rd Thursdays after 4:30pm until Sunday noon

Method of payment

Select a payment option Providence Easy Pay (PEP) Payroll Deduction- PROVIDENCE EMPLOYEES ONLY Pay in full. Send full payment now Pay in two installments: now & July 15, 2013 (+ $10 administrative fee) Make special payment arrangements subject to agreement.

Total cost

$
The total cost represents the cost of a share, plus any administrative costs and special options.

Dontate to the scholarship fund

Sauvie Island Organics is raising scholoarship money for the 2013 season to help folks who wouldn't otherwise be able to afford the CSA. We appreciate your support.
Your gift $ (amount in dollars)

Please mail either your full or half paymentnow.

Mailing address for payments

Sauvie Island Organics, LLC
20233 NW Sauvie Island Rd.
Portland OR 97231

For new members - how did you hear about us?
(Family or friend, web search, postcard, etc.)

Please enter the name(s) and email addresses of all those who wish to get our weekly email updates.

Anything else we should know or you wish to tell us?

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