First Name |
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Last Name |
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Phone |
Your primary contact number
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Email |
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Type of CSA Share |
If you'd like more than one of a share type, choose "Other" as well and fill in the text box.
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Pick-Up Location |
Providence Location Sold Out
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payment plan |
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Add-ons |
If you'd like more than one of an add-on, choose "Other" as well and fill in the text box.
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Payment |
Select whether you intend to pay with check or electronic benefit transfer (EBT)
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donation |
Would you be interested in making a donation to support Crossroads' kitchen?
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Captcha |
10 × 4 = ?
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