Stony Loam Farm Membership Form 2011



Name: _______________________________________________________

Phone: _______________________________________________________

Address: _____________________________________________________

E-mail: ______________________________________________________

   We would prefer to communicate via e-mail.  Is this okay with you? ____yes  ____no     


_____ Half Share at $425

_____Small Family Share at $525

_____Large Family Share at $625              (Installment plans are available upon request)

_____Underwriters share to support local food shelf donations and/or low-income shares  through NOFA Farm Share Program

Send to:   STONY LOAM FARM, P.O. Box 282, Charlotte, VT  05445