Valley View Farm
CSA Shareholder Application
Shareholder Contact Information:

Adult Names:  ______________________________________________________________________________

Street Address: _____________________________________________________________________________

City: _____________________________         Zip: _________

Phone: ________________________

Email: _________________________      
Share information:

number of shares _______ X   $150.00 per share =  _________

For planning purposes, please indicate what quantities you will desire of the following for the coming year.

Chicken     ______

Duck         ______

Goose      ______

Holiday turkeys    _____   (approx size desired ________ )

Call Kathy at (207) 320-1969 for information regarding bulk beef and/or pork orders.
Please send completed form along with a non refundable $50.00 deposit to:
Valley View Farm
Attn: CSA
1200 Sopers Mill Rd
Auburn, Maine 04210
Payment in full due no later than May 15, 2014. We will credit your account with a 10% bonus if payment is received
prior to May 16, 2014. Payments received after that date will not be credited with this bonus. Please make checks
payable to Valley View Farm.