FarmShare 2010 Subscription Form Survey

Welcome to FarmShare's 2010 Subscription Application!

Please complete the information below to reserve your 2010 FarmShare. Once your application and deposit have been received, a subscription confirmation will be sent to the email address provided.

Thank you for your interest in FarmShare and your support of fresh, locally grown food!

*
1. Please let us know if you are:

Please let us know if you are: a returning FarmShare subcriber (welcome back!)

a new FarmShare subscriber (nice to meet you!)

*
2. Your Contact Information:
(Note: FarmShare uses this information to contact you DURING BUSINESS HOURS regarding your FarmShare subscription, delivery reminders, payments, updates, etc.)

Your Contact Information: (Note: FarmShare uses this information to contact you DURING BUSINESS HOURS regarding your FarmShare subscription, delivery reminders, payments, updates, etc.) Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

3. Are you sharing your FarmShare subscription with anyone? (i.e. sharing the cost and/or responsibility for pick-up).

Are you sharing your FarmShare subscription with anyone? (i.e. sharing the cost and/or responsibility for pick-up). yes

no

4. If yes, with whom will you be sharing your FarmShare?
(Note: FarmShare uses this information to contact them DURING BUSINESS HOURS regarding your FarmShare subscription, delivery reminders, payments, updates, etc.)

If yes, with whom will you be sharing your FarmShare? (Note: FarmShare uses this information to contact them DURING BUSINESS HOURS regarding your FarmShare subscription, delivery reminders, payments, updates, etc.) Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

5. What do you enjoy most about fresh, locally grown fruits and vegetables?

What do you enjoy most about fresh, locally grown fruits and vegetables? Cooking

Gardening

Eating

Other:

6. What are your favorite fruits & vegetables?

What are your favorite fruits & vegetables?

7. What are your least favorite fruits & vegetables?

What are your least favorite fruits & vegetables?

8. Where did you hear about FarmShare?

Where did you hear about FarmShare? Forest City Enterprises/Tower City Management

Your Employer

Friend/Coworker

Internet/Website

Postcard

Newspaper

Other (please specify)

9. Were you referred by another FarmShare subscriber? If so, who?

Were you referred by another FarmShare subscriber? If so, who?

10. Is there anything else you'd like us to know about you?

Is there anything else you'd like us to know about you?

*
11. What type of FarmShare subscription would you like to reserve?

What type of FarmShare subscription would you like to reserve? Full-Season Subscription WEEKLY DELIVERIES, $600

Full-Season Subscription BI-WEEKLY DELIVERIES, $350

U-Pick Subscription, $40 per week

*
12. Please choose the FarmShare delivery location that works best for you.

Please choose the FarmShare delivery location that works best for you. Downtown Cleveland (Tower City)

Independence (tba)

Cleveland Heights (tba)

*
13. The FarmShare Handshake Agreement: As a FarmShare subscriber, I am making a seasonal commitment of weekly or bi-weekly FarmShare deliveries as indicated above. I agree to pick up my FarmShare delivery each week at the designated time and location for my workplace (or make arrangements to have someone pick it up for me). I understand that I am not eligible for a refund if I do not pick up my weekly FarmShare. Unclaimed FarmShare deliveries will be donated to charity.

The FarmShare Handshake Agreement: As a FarmShare subscriber, I am making a seasonal commitment of weekly or bi-weekly FarmShare deliveries as indicated above. I agree to pick up my FarmShare delivery each week at the designated time and location for my workplace (or make arrangements to have someone pick it up for me). I understand that I am not eligible for a refund if I do not pick up my weekly FarmShare. Unclaimed FarmShare deliveries will be donated to charity. I agree

*
14. Please choose your method of payment below:

Please choose your method of payment below: Full-Season Weekly: Payment in full of $600 will be submitted by May 20, 2010.

Full-Season Weekly (payment plan): $100 will be submitted by May 20, 2010. Two payments of $250 will be due June 17 and August 26.

Full-Season Bi-Weekly: Payment in full of $350 will be submitted by May 20, 2010.

Full-Season Bi-Weekly (payment plan): $100 deposit will be submitted by May 20, 2010. $250 will be paid June 17.

U-Pick Subscription: $40 per week due one week in advance of delivery. I will contact FarmShare to select my delivery weeks and submit payment.

FarmShare supports a thriving local economy. To keep our prices competative and keep your dollars working in our local community, we accept payment by cash or personal check rather than credit cards.

Please make check payable to FARMSHARE OHIO and mail to:

FarmShare Ohio
PO Box 1998
Cleveland, OH 44106

In order to reserve your FarmShare subscription, FarmShare must receive your deposit or payment in full ONE WEEK PRIOR TO YOUR FIRST DELIVERY.

FarmShare subscriptions are available on a first-come-first-served basis.

Subscription confirmation, delivery details, payment reminders, and other FarmShare correspondence will be sent to the email address provided above. Should this email address change, please notify us.

If we can answer questions or provide additional information about your FarmShare subscription, please contact us:

tel: 216.225.6311
email info@FarmShareOhio.com
web: www.FarmShareOhio.com

Thank you for joining FarmShare!

FarmShare 2010 Subscription Form

*1. Please let us know if you are:

*2. Your Contact Information: (Note: FarmShare uses this information to contact you DURING BUSINESS HOURS regarding your FarmShare subscription, delivery reminders, payments, updates, etc.)