Print this form out. 

Mail the completed form and your check by March 1, 2015 to:

            Martha Goodlett
            3213 36th Ave. S.
            Seattle, WA 98144 
	
           -----------------------------------------------			
           MAKE YOUR CHECK PAYABLE TO: Lake Cavanaugh Farm 
           -----------------------------------------------
					
NAME_______________________________________________________ 

ADDRESS____________________________________________________ 

___________________________________________________________ 

HOME PHONE (___)___________________________________________

CELL PHONE (___)___________________________________________

e-mail address_____________________________________________


I will pick up my produce at:  

_____  Wallingford site (2306 N 46th St)

_____  Mount Baker site (3213 36th Avenue S.)

_____  Central Area site (916 27th Ave.)

_____  Conibear Rowing Practice


_____  Enclosed is a check for $650 for one share for 20 weeks

_____  Enclosed is a check for $325 as a deposit,
       with the remainder due May 1, 2015
       
       
My preference for a pick-up day is:

_____  Monday

_____  Wednesday

If you have questions, contact Martha Goodlett at 206-300-7768 or lakecavanaughfarm@gmail.com