Meat Csa Member Application

Millsap Farm Meat CSA Name_________________________________ Address ______________________________ Phone ________________________________ E-mail________________________________ How did you hear about us__________________________ Will you split this share, [ ] yes, with whom: Name_________________________________ Email __________________________________ Phone _________________

6 Month Subscription (October-March 2009) Share Size

Number of Cost per shares share

MIXED MEAT POULTRY ONLY EGGS

Extended cost

$390.00 $220.50 $54.00

Total

[] I will pay in full today. Make checks payable to Millsap Farms or Credit Card-[] Master Card, [] Discover, [] Visa Card Number ______________________ Exp Date ____ Last 3 Digits on back _______ Signature ______________________________________________________ * ____ I will pay in installments (please deposit at least 50% today, and the balance by December 14th, 2009) CSA Agreement: I wish to purchase a share of the Millsap Farms Winter 2009-10 meat or egg CSA. The enclosed payment, as noted above, makes us “farming partners” and makes us eligible for 6 months of the best meat available, to be picked up at the farm the first Tuesday of each month, between 4p.m. and 6p.m. I also agree to contribute 4 hours of labor on the farm, helping to care for the animals Signed______________________________________________ Mail to : Millsap Farms, 6593 N Emu Lane, Springfield, MO 65803

Curtis and Sarah Millsap 417-839-0847 [email protected] www.millsapfarms.com