CSA Member Name *

First Name

Last Name

Date of the Thursday you will be gone

submit separate forms for each CSA Thursday you will miss. See CSA Schedules Under "Member Resources Tab" to see the dates you are scheduled for.

MM

DD

YYYY

What Would You Like to do with your missed share? (CHOOSE ONLY 1 OPTION) *

Make up my share on a different pick up day. *We need a 5 day notice for this to be possible* (let us know by Saturday). Select reschedule date below.

My friend or family member will pick it up for me!

Pick-up my share at the farm anytime between 10am Thursday and before dark on Sunday - 1415 S Cheyenne St 84104

donate

Choose a Thursday to Make-Up Your Missed Shares

If you are a half-share member, you are welcome to "make-up" your missed share(s) on any thursday, not just the ones you are normally scheduled for.

MM

DD

YYYY

I have double checked the dates and information I have provided, and they are accurate! *

Yes!