The Happy Box CSA Program

The Happy Box”- Fulton Farms Organic Community Supported Agriculture Program

 Application Form 2012

Please fill in the requested information below:

Name:______________________________________, Tel:___________________,

Email:________________________________________

Street address:___________________________________, City:______________State/zip code________

I have visited the Happy Box web site –www.fultonfarmsorganic.com and I have read about the method of growing organically, the picking, packing, and delivering system, registration, cost, and payment, the difference of the offered services.

I choose one or more of the following 8 services: (Please circle the Services you choose)

Standard Small Service (21$/week, requested deposit with this application-84$),

Standard Regular Service (31$/week, requested deposit with this application-124$),

Premium Small Service (26$/week, requested deposit with this application-104$),

Premium Regular Service (36$/week, requested deposit with this application-144$)

Locavore Small Service(21$/week, requested deposit with this application-84$)

Locavore Regular Service (31$/week, requested deposit with this application-124$),

Locavore Premium Small Service( 26$/week, requested deposit with this application- 104$),

Locavore Premium Regular Service (36$/week, requested deposit with this application- 144$)

The Happy Box produce that is not homegrown is always 100% certified organic, the homegrown produce is overall 95% certified organic. We still have 5ac out of 40ac that are 3rd year of transitioning. This 5 ac will become certified organic in the summer and fall of 2012 when we will become 100% organic. Until then the transitional produce coming from this 5 ac is optional. If you choose not to receive it we will substitute it with similar organic produce. The other optional produce is homegrown organic wheat grass and sunflower micro-greens (for details visit our website)

I choose not to receive the following optional produce: (Please circle any of the optional produce that you never want to receive). If you are not sure and you want to try them, you can make that choice any time later.

                  Transitional,      Wheat grass,      Sunflower greens

I am going to pay my monthly bills within 2 weeks of receiving (only checks or money order to Fulton Farms are accepted)

I am going to read every week’s newsletter for some important information that may be included there.

I understand that the deposit and $20 registration fee requested with this application form are not refundable. The deposit will be used as payment for my last 4 deliveries.  

I understand that only 6 delivery cancellations are allowed per year and only 4 cancellations after July 1^st. It is my responsibility to inform the program about the canceled dates, and adjust payment accordingly. The monthly bill is for all possible deliveries scheduled for the month. If I have overpaid it is my priority to mark the overpaid amount on future bills and use it as credit.

I understand that in the organic fields there is presence of plant eating and beneficial insects. All of the organic produce is selectively hand harvested, but it is still possible that some insects may be present. It is my responsibility to wash thoroughly all of the produce I receive before consumption.

Fulton Farms Organic does not have storing and washing facilities and all organic produce is packed immediately after picking the same day of delivery. What you receive looks like it has been picked from your own garden. For instance lettuce picked on a rainy day may have soil particles on it splashed by the rain and may need extra washing when you receive it!

I understand that the reusable plastic containers for the Regular size box services (Standard, Premium, Locavore) are intended only for short use while transporting the produce from the farm to my home. The produce should be removed from them and washed as soon they are received. I shall take proper care of them, returning them clean, dry and packed in the same order in the box as when they were received.

I understand that wholesale organic produce unlike conventional produce is not uniform in quality and appearance. It has not been treated with fungicides before shipping and simple bruising during transporting can result in spoiling. Packers are removing all bad  fruit or veggies if they come across  but it still may be possible for them to unintentionally place some in my box occasionally. It is my right to e-mail and inform the Program manager if this happens too often.

I understand that I have the right to cancel the Service permanently at any time, however the 20$ registration fee and the deposit are not refundable. If I intend to cancel permanently I should not pay my last 4 deliveries. I also must inform the Program about my permanent cancellation and have my empty containers ready in good order to be picked up the following week. If I want to join the program again in future a new 20$ registration and deposit will be required.

I understand that the Program can also terminate my service for one or more of the following reasons:

1. The records show that no payment has been received from me by the end of the month.

2. I have repeatedly returned dirty, damaged, or missing containers, not packed properly.

3 The delivering area has changed and it has become very inconvenient and expensive for the Program to continue my weekly deliveries and that I will be informed at least a month in advance in such an event.

4. There are some specific delivering problems like dangerous dogs, long distance of carrying the box, inconvenient multiple story building delivery, etc.

I am including a check or money order to Fulton Farms for the amount of  ­­­­­­­________ dollars. ( $20 registration fee plus deposit).

I like to start the 2011 season the   1^st,  2^nd,  3^rd,  4^th  week of March, April, May, or A.S.A.P. (Please circle the week and the month you want your first delivery.)

  Signature:________________________________,     Date:__________/2012

This form was prepared by Milan Pajev, “Happy box” program manager on 01/13/2012

For printer friendly version of this form please click here.

For questions please e-mail us: fultonfarmsorganic@yahoo.com or call: 937-572-7529     

Please print this form , fill it out, keep a copy of it for your records, and mail it with your payment (only checks or money order to Fulton Farms) to:

The Happy Box, Fulton Farms, 2393 State Route 202, Troy, OH 45373

For all premium services we need you to fill up and mail to us a produce choice form , click here or go to our web site: www.fultonfarmsorganic.com., click on Premium Services