A Family Market Place
Farm Fresh Produce
CSA Sign-Up Form
Flowers & Plants
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Size of Share
$25 / Week - Single Share (Minimum of 1/2 Bushel -- Feeds 1 to 3 Adults) - Most Popular Selection
$45 / Week - Small Family Share (Minimum of Full Bushel -- Feeds 3 to 6 Adults)
$90 / Week - Large Family Share (Minimum of 2 Full Bushel -- Feeds 6 to 9 Adults)
Duration of Subscription:
Full Season (20 weeks)
Half Season (10 weeks) - Default Start Date is July 12th
Half Season (10 weeks) - Choose Your Start Date
Enter Start Date (Half Season Only)
Pick-up Location (All Locations/Deliveries will take place each Thursday)
A Family Market Place (our farm) 3142 E. Shaulis Road, Waterloo
Home Delivery: Add $5/wk.
Hansen's Farm Fresh Dairy Outlet in Cedar Falls (Pick up between 2:00 PM to 9:00 PM)
Hansen's Dairy Waterloo (previously Moo Roo's) (Pick up between 2:00 PM to 9:00 PM)
Newbo City Market - Cedar Rapids (Pick up between 4:00 PM - 8:00 PM)
Parkersburg Hardware - Parkersburg Iowa (Pick up between 3:00 PM - 8:00 PM)
Kimball Ridge Farmers Market (Pick up between 3:30 - 6:00 PM) - Tuesday - Market Style
Downtown Waterloo Farmers Market (Pick up between 8:00 AM - Noon) - Saturday - Market Style
Alliant Energy (Employee Only) - 200 1st Street SE, Cedar Rapids
Other: Please specify in message field below.
Options for Payment:
Payment in Full
Check - Make Payable to: A Family Market Place
Debit/Credit (Visa/MasterCard) Call to set up payment
Employer Payroll Deduction (List employer below)
Employer Name: (for payroll deduction only)
Refer A Friend Program (Add the Name of the Person that Refered You to Sign Up, & We Will Give Them One Free Week off Their Subscription.)
How Did You Find Us?
See Our "Get Fresh Locally Grown..." Poster
Read one of Our Double sided Rack Card/Brochure
Info Provided Thru Your Employer
Thank you for submitting your information for a CSA Subscription. We will review your information and will confirm your request within 2 business days.
If you do not receive conformation from us please let us know as your submission might not have gone thru.
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