Farm Fresh 2023 PAYMENT Please fill out this page to pay for you shares. Question Title * 1. Your Name Question Title * 2. Preferred Email Question Title * 3. Phone Number Question Title * 4. What shares would are you purchasing? Individual, Farm Fresh Share ($99) - 3 to 4 different veggies PLUS 1 to 2 different fruits delivered bi-weekly for 6 deliveries Family, Farm Fresh Share ($195) - 6 to 7 different veggies PLUS 1 to 2 different fruits delivered bi-weekly for 6 deliveries Jersey Fresh Specialty Share ($95) - 1 bag of local specialty items delivered once a month for 3 deliveries Flower Share ($95) - Fresh flowers delivered bi-weekly for 6 deliveries Question Title * 5. Payment Options Check, made payable to Summer Wind Farms LLC. Sent to AtlantiCare Health Engagement ATTN: Joe Marino Question Title * 6. AtlantiCare Employee Clock Number Next Page