2010 Provisions CSA Membership Registration
Drop-Sites:
Tuesday: (Seattle) Fremont (Fremont & 36th) Wallingford (40th & Eastern) Crown Hill (Holman & 15th) Phinney Ridge (1st & 65th) Shoreline (175th & 22nd) Bellevue (NE 2nd & 128th Ave) Green Lake (Wallingford & 85th) Ballard (26th & 67th) Kirkland (65th & 111th Ave) Tacoma (SW,
Wednesday: (Portland) Alberta * 3-7:00 (Alberta & 30th) Hawthorne (Hawthorne & 35th) MLK (MLK & 7th) Centralia (Main & Tower Ave)
Thursday: E. Olympia * 1-9:00 (18th & Capitol Way) W. Olympia * 1-9:00 (Muirhead & Division) Capitol Hill (10th & Harvard) Georgetown (S. Corson & Bailey) Queen Anne (1st & Blaine) Ravenna (65th & 32nd) Seward Park (50th & Alaska) Beacon Hill (Beacon Ave S, 98144) W. Seattle (42nd/ Ave.) W. Seattle WSNMC (California Ave SW) All Recipes (Employees Only) Belltown (PARC Residents only)
----------------------------------------- Please print/copy and mail or email bottom portion with your payment -----------------------------------------------------------
Name: ______________________________________________________________________________
Address: ____________________________________________________________________________
Helsing Pick-up Location: ______________________________________________________________
Phone: ______________________________________________________________________________
Email:_______________________________________________________________________________
□ - I would like newsletters sent via email.
□ - I would like newsletters to accompany my share each week.
As a shareholder, I agree to pick up mushrooms within the agreed hours at the agreed upon location. All mushrooms not picked up on time will be given to the food bank. If I wish to terminate partnership, I will contact Provisions by phone immediately.
Signature:__________________________________________Date:_______________________________
Please make checks payable to Provisions Mushroom Farm and mail to our address below. Thank You!
Provisions Mushroom Farm - P.O. Box 233 - Olympia, WA. 98507