CSA
Membership Application

STOP!  You do not need to fill out this application.  We've reached 200 members!  The application process is now over for 2008.  IF any spots open up, we'll email those on the waitlist. 

So PLEASE DO NOT FILL OUT THIS APPLICATION. Thank you!!

If you have not yet been placed on the waiting list, please email Gina at victoryfarms@comcast.net to be added.

Thank you!



* all fields are required
Name:  
Address:  
City:  
State:  
Zip:  
Home Phone:  
Alternate Phone:  
Email:  
Email Confirmation:  
Have you been a member of a CSA before?  
Do you currently try to purchase organic produce when available?  
Are you willing and able to pick up your produce weekly from the 17th Street Farmer's Market or the Byrd House Community Market in Oregon Hill (additional location TBD)?  
If not, can you make arrangements with a friend or family
member to pick it up for you or are you willing to have it
donated to a food shelter?
 
How many meals per week do you eat at home?  
How did you hear about us?  
 
 


 
       

victoryfarms@comcast.net | 804-559-8833 | ©2007 Victory Farms Inc.