2008 Membership Enrollment Form

Wild River Organic Farm

PO Box 1669, Cave Junction, OR 97523 ~ 541-592-4292 ~ wildriverfarm@gmail.com

2008 Membership Enrollment

Name _____________________________________

Address ___________________________________________________________

Phone number(s) ___________________________________________________

Email ________________________________

Membership Fee Paid _________________ Date Paid ____________

($75 to $150 sliding scale if paid by May 11th or $95 to $170 if paid after)

Best way to contact you (circle one): phone email other_________

Best day for pick up __________________

(This will help us decide which day to schedule pick-ups. We will choose the day that works best for most of the membership.)

Interested in delivery for a fee ($5)? _________

(We are considering delivery, depending on interest level. Let us know if you are interested and we will let you know if we will be offering this service.)

Please return this along with Product Request Form to WROF.