Rivendell Ranch
CSA

YES! I'd like to purchase a share of the 2005 Harvest at Rivendell Ranch Organic Farm.
By completing this form and returning it with my payment, I agree that share selection and quantity will be determined by the actual weekly harvest, and I will be responsible for picking up my weekly share.

Name: ______________________________________________

Address: ___________________________________________

City, Zip: _________________________________________

Phone: _____________________________________________

email: _____________________________________________

I would like Plan (please choose one):

[   ] Single Share $450 (for 1-2 people)

[   ] Family Share $780 (for 3-4 people)

I will pick up my share:
[   ] On Farm
[   ] Montesano Drop-off
[   ] Hoquiam Drop-off
[   ] Ocean Shores Drop-off

Payment: Please make your check payable to Rivendell Ranch. A limited number of shares are available. Your share is reserved when we receive your signed application and check.

Signature: __________________________________________

Please mail this form with your check to:

Rivendell Ranch
100 Hensel Rd
Hoquiam, WA 98550

(360) 987-0088
RivendellRanch@centurytel.net