New Customer Registration Form

Farmer Mai Winter 2020 Grain Share Pilot

Please complete by 8PM, Friday, Nov 20
Full Name *

First Name Last Name
Phone Number *
E-mail *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Which site would you like to pick-up from? *
What is your preferred payment method?
Only PayPal and Venmo can be accepted at this time.
What is your PayPal or Venmo address/handle?
Please provide the address/handle associated with your preferred payment method. You will receive a request for a one-time payment of $150.00 to secure your share.
If Share spots are full, would you like to be (check all that apply): *

added to the waitlist for Winter 2020 Shares? informed when Summer 2021 Shares registration opens? notified about a la carte flour availability at either pick-up site?
Would you like to receive information about (check all that apply):

varietal history? baking properties? farming practices? what to make with these cool varieties?
Do you have any questions or comments about the Grain Share?
Thank you for your interest in a Grain Share.

Shares will be filled in order of registration date. You will receive a confirmation email that will request payment by PayPal or Venmo. If payment ($150) is not received by Monday, November 23 at 8 PM your spot will be offered to a waitlisted applicant. Only one share per person/family.
Should be Empty:

Farmer Mai Winter 2020 Grain Share Pilot