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CSA Subscription Form

Thank You for Supporting the Family Farm

Nottawa Fruit Farm agrees to provide the subscriber with 12 boxes of farm fresh produce
in the following months-June-2; July-3; August-3; September-3; October-1. The assortment will
vary throughout the season and every attempt will be made to acheive a variety depending on
the growing season.

You will be notified of the exact dates per month which will be determined based on the weather
at a later date. Due to the vary perishable nature of farm fresh produce, dates can be delayed or
deferred.

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SUBSCRIBER & GROWER AGREEMENT

Name_______________________________________e-mail____________________________

P.O. Box or Street/Road Address__________________________________________________

City_______________________________________State____________Zip________________

Full Subscription Price is $200.00. The subscriber will receive twelve (12) 'specially-prepared'
boxes of fresh home-grown produce throughout the season (June-October).

I would like the folloing pick-up location_____________________________________________
The determiner being that there are five subscribers at this location, and it is within thirty miles
of Centreville, Michigan.

Yes, I will pick up my boxes at the Farm Market____________________(please initial this line)

Signature___________________________________________________Date______________

Please send personal check or credit card number and completed form to:

Nottawa Fruit Farm
24878 Hwy M-86
Sturgis, MI 49091

Grower Signature_____________________________________________Date______________

A copy of this form with the grower's signature will be returned to you after payment and will
serve as confirmation of your order and receipt for your payment.

Thank You for Supporting the Family Farm