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Name:______________________________________________________
Address:____________________________________________________
City:___________________________________Phone:_________________
Cell:______________________________Number in household:____________
____ One time. Non refundable membership fee: $50.00
Share options:
___ Plan 1: A full share of veggies, fruit, herbs and eggs, delivered to my home for 22 weeks
beginning first week of May, 2011 : $1078
___ Plan 2: A full share of veggies, fruit, herbs delivered to my home for 22 weeks beginning
first week of May, 2011: $1012
___Plan 3: A half share , same as plan 1 delivered to my home every other week for 22 weeks
beginning the first week of May , 2011 (11 weeks) :$539
___ Plan 4: A half share , same as plan 2 delivered to my home every other week for 22
weeks beginning the first week of May, 2011 (11 weeks) :$506
Your total payments:
_______ Non-refundable membership fee ( one time only)
_______ Plan1
_______Plan 2
______Plan 3
______ Plan 4
_______ Total:
____ I'll pay in full.
_____ I'll use a payment plan. ( Enclosed is my one time non refundable membership fee.
Divide the total of your plan by 4 and send one payment each month for 4 months. All fees
must be paid by April 1, 2011.
_____ I need a custom payment plan. I will enclose my membership fee and a list of dates
and amounts I will pay, knowing I must have all my share payments made by April 1, 2011
____ I will pay by credit card. To do so I will press the "Buy Now" button on the CSA page of
this website below the membership fee and the share I want to buy.
Send checks payable to : Bowen Creek Farm to Bowen Creek Farm, 1030 Bowen Creek Rd.,
Niangua, Mo 65713
Terms and Conditions:
Bowen Creek Farm agrees to provide a cooler of Farm Fresh fruit, produce and herbs each
week, in season, for 22 weeks. Variety of produce shall be at the discretion of Bowen Creek
Farm. Subscription will start May 4, 2011 and end September 28, 2011.
Please make arrangements for your produce if you are out of town or on vacation. We cannot
carry over shares to any other time or week. You can , however, pick that week up at the
farm on a day agreed to by Bowen Creek Farm and the share holder.
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