2023 Red Truck Homestead CSA form – Red Truck Homestead

Name

Phone Number

Yes No May we text you at this number?

Billing Address

Delivery address is same as billing address.

Yes No

select state

Are you a returning CSA member or prior market customer?

Yes No

Did you hear about us through www.pnwcsa.org?

Yes

CSA Pickup Options

Pickup location - Toggle

@ The Homestead - 11330 NE Prescott Street, Portland - Saturdays 5-7pm

@ King Market - NE 7th & Wygant - Sundays 10am-2pm

Payment Options

Once you have selected a payment option,
please review our contract and submit your form.
We will email you details for your preferred payment method.
Please let us know your intended payment date if it is not within 1 week of submitting this form unless a Payment Plan or SNAP arrangement has been selected.

Please select a payment options below.

Payment Options

Cash: in full

Check: in full

Venmo or Paypal: in full

Bill me: I would like to pay online.

Payment Plan: $325 by March 1 and $325 by May 1.

I will use my SNAP benefits. ($250 Double-Up Bucks discount). We will contact you with details.

Contract

Please read the 2023 Red Truck Homestead CSA Contract linked below.

By submitting this form I agree to the terms in the contract. If I have trouble viewing it, I will contact Red Truck Homestead for an emailed copy.

I understand that, although unlikely, the farm may change parts of this agreement related to production and distribution from time to time. I understand that they will contact me via email in advance of any changes to this agreement.

I have reviewed and agree to the
2023 Red Truck Homestead CSA Contract. *