Fresh Harvest Sign-Up Form

Print and mail in

FRESH HARVEST SIGN-UP FORM

 

Name: _____________________________________

Address:  ______________________________________________________

              _________________________________________________________

Telephone(s):   _______________________________________________________

Email   _________________________________________ 

Circle Membership Type:        Single     Couple       Family        additional children #  _______

Month(s):   June     July     August     September

Total Due:   $  __________________

Please copy and paste this page into Word, (or comparable), then complete,  print, and mail with check to:

Silver Wheel Farm

141 Porter Rd.

Harrisville, PA. 16038

You will receive an email or phone call to acknowledge receipt when it arrives at the farm.

Questions?  call 724 735 4054 (Lori)