Gravel Knolls Farm

Local Certified Organic Produce

Yes, I want to be a part of the Gravel Knolls Farm, community supported agricultural program.  I understand the risks involved when working with Mother Nature and that the farmer will do his best to supply me with a variety of seasonal produce for about 25 weeks of the harvest season.

I agree to pay $375.00 for a full share or $200 for a half-share for the 2005 harvest season.  I will come at my scheduled pickup time for fresh organic vegetables each week, or make accommodations for another to pick up my week's share.

Please circle which share size you desire:

Full Share   $375

Half Share   $200

Please circle which day would work best for you most often to pick up produce:

Monday between 3 p.m. and 7 p.m.

Thursday between 3 p.m. and 7 p.m.

Name: ________________________________

Address: ______________________________

______________________________________

Phone: ________________________________

e-mail address: __________________________

Signature _______________________________

Return this form with your check made payable to:

Gravel Knolls Farm

and mail to:

Linda Rosselot

6538 Dimmick Road

West Chester, OH 45069

** Please retain a copy of this application for your records.