Tarleton Tavern Farm
4333 Frankfort Road
Georgetown, KY 40324
502-682-3750
Website: www.TarletonTavernFarm.com
Email: TarletonTavern@aol.com
To order, print and fill out this order form.
You can email it or mail it back to us along with your check.
VEGETABLE/HERB
CSA ORDER FORM
Name:___________________________
Address:_________________________
City/State: _______________________
Zip: ____________________________
Phone: __________________________
Email: __________________________
Delivery City: ____________________
Today’s Date: ____________________
2011 VEGETABLE / HERB CSA:
SINGLE SHARE __________________ __________________
# of shares Price
TOTAL DUE $______________
2011 Prices:
Single Share: $525.00 for 20 weeks
If it is not possible to make payment in full up front,
contact us to discuss other options.
ARE YOU SHARING WITH ANYONE?
If so, please fill out the following for our records:
Name:___________________________
Address:_________________________
City/State: _______________________
Zip: ____________________________
Phone: __________________________
Email: __________________________