Gourmet Produce Box
Community Supported Agriculture

Name ______________________________________________________________

Address ____________________________________________________________

_____________________________________________________________________

Phone Cell _______________________ Phone Message _______________

E-mail ____________________________________________________________

Pickup Location:

Downtown: Citizen Hotel-Grange Restaurant,

Hot Italian, Lucas, Waterboy, Mulvaneys, One Speed

Land Park: Taylors Market

East Sacramento: One Speed, Roxys

West Sacramento: Les Schwab, Ranch

Davis: El Macero, Fasulos

Charmichael: Oak Café (ARC) El Camino Gardens

Roseville: Institute of Technology, Karens Bakery

Placerville: Sequoia

Tahoe/Truckee New Moon Tahoe City, New Moon Truckee,

Soule Domaine Restaurant, Ritz Carleton

New location ____________________

What day of the week would you like to pickup T, W, TH, F, Sat

Start Date ___________________ Quarter Rate _________________

Prorate if diff than Qtr ___________

Check Enclosed _________

Visa Master Card Discover

Name on Card ________________________________

To protect your card, we will call you for the number.

Or you may call Suzanne at 916.919.1843