Community Supported Agriculture

EXISTING MEMBER PAYMENT FORM

Thank you for being a part of Fernbrook Farms CSA! We are excited to be growing food for you and your family. CSA members can use this form to make payments for their CSA Share.

Questions? Give us a call (609-298-0029) or send us an email (csa@fernbrookfarms.com).

Thank you!

Member Information

First Name *

Last Name *

Phone Number *

Email Address *

Do you have a Full Share or a Ten Week Share? *

Payment Information

How would you like to pay? *

Pay By Credit Card

*Please note that the final charge to your credit card will include a 3% processing fee. For example: If you pay the $150 deposit you will see a charge of $154.50 on your statement.

** We can not accept American Express cards OR debit cards. Please use a VISA, Mastercard, or Discover credit card. Thank you **

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

CVV *

Zip Code on Card *

Payment Options *

Pay first installment of $255 (due by February 15th, non-refundable).

Pay second installment of $255 (due by May 1st, non-refundable).

Pay both installments, $510 (non-refundable).

Other (please type in your payment amount) Other (please type in your payment amount)

Payment Options *

Pay second installment of $210 (due by by February 15th, non-refundable).

Other (please type in your payment amount) Other (please type in your payment amount)