We are now taking 2012 main season CSA memberships. Please fill out and send the form below to be added to our mailing list for this and future CSA seasons and notifications of Beausol events. Your share is not confirmed until we receive a payment. Thank you. Required fields marked with an asterisk.*
First Name*
Last Name*
Email Address*
Mailing Address*
City*
State*
Zip Code*
Phone 1*	- -
Phone Type Listed Above*	Home Cell Work
Phone 2	- -
Phone Type Listed Above	Home Cell Work
Share Size (select one):*	Full Share Three-quarters Share Half Share Flowers
Additional Options:	Doorstep delivery (Add $50 for the season). We apologize. Our home delivery is fully booked for 2012. We cannot accept any more home deliveries
Pickup Location (select one):*	At the Farm 5 Points/Whitaker Mill Road area of Raleigh Meredith College (for Meredith staff and students) S. Elliott Rd. Parking lot of Chapel Hill We do a limited number of home deliveries each year. Unfortunately, our home delivery slots are all full for 2012.
Number of people in your household (helps us assure our share sizes are apporpriate):
Suggestions for crops of varieties to grow or other comments:
Food allergies we should know about (or vegetables you just refuse to eat!):
If you don't mind, we would like to know how you found out about us?	LocalHarvest.org search RaleighCSA Yahoo group Other internet search Personal contact with Harry or Deb CFSA Farm Tour Referral by a friend (So we may know who to thank.) Other
Please make check payable and mail to: Harry LeBlanc, 139 Beausol Lane, Pittsboro, NC 27312-4135