3 Bluebirds Farm Egg Membership Signup

3 Bluebirds Farm Egg Membership Signup

Thank you for joining our egg membership. Each dozen supports meaningful job & socialization training for individuals with autism while providing fresh, pasture-raised eggs from hens raised with care. Please complete the form below.
Contact Info
Full Name*

First NameLast Name
Email Address*
example@example.com
Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Where did you hear about us?
Membership Plan
Weekly -- $28 every 4 weeks (plus processing fees)Every-Other-Week -- $14 every 4 weeks (plus processing fees)
Payment Agreement
I understand my membership will be set up by automatic billingI understand billing occurs every 4 weeksI understand my membership will continue until I request a change or cancellation
Pickup Day & Agreement
Choose your primary pickup day (choose ONE):*
Date you wish to start membership & pickup:*

MonthDayYear
Date
I will pick up during my chosen window when possibleI understand eggs may be placed in the cooler inside the farm stand after 3pm on my pickup day until the following morning if I am unable to make my pickup window.I understand that any unclaimed eggs will be released to other customers on Friday to ensure freshness.
Customer Experience

As part of our program, individuals with autism are actively involved in preparing and distributing eggs. If you arrive during your pickup window, you may be greeted by one of our participants who will help hand off your eggs. This is an important part of building real-life social and vocational skills.
Communication

You will receive both email and text reminders related to your egg membership.
Confirmation Message With Payment Link
Thank you for joining our egg membership!

Once you have submitted this form and we have entered your information into our system, you'll receive a confirmation email from us that includes your start date and a secure link to set up your payment through Square and to activate your membership.
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3 Bluebirds Farm Egg Membership Signup

Contact Info

Membership Plan

Payment Agreement

Pickup Day & Agreement

Customer Experience

Communication

Confirmation Message With Payment Link