Community Supported Kitchen Membership Form

First Name *

Last Name *

Email *

Day Phone or Cell Phone *

Evening Phone

Address *

City *

State *

Zip *

Information about you and your family. * Please share any dietary choices/restrictions (i.e. vegan or vegetarian), food allergies or anything else we should know about your diet.

What are some of your favorite foods? *

How often do you anticipate ordering from the CSK? *

Every Week
Every Other Week
Once a Month

What type of CSK membership do you want? * We offer four different types of CSK memberships. For more information on these membership go to http://sites.google.com/site/localsproutscooperative/community-supported-kitchen. If you have any questions about these memberships, feel free to contact us at food@localsproutscooperative.com or 615-9970

Local Choice CSK Membership $50 Starting Membership If you pay more than $100 you get 10% return on your initial investment, so a $100 membership gives you $110 credit to order off our weekly menu. We also accept a limited number of Time Dollar memberships every 3 months, who pay 5-10 Time Dollars for $50-100 of food credit. Member are expected to order once a month but don't have to order every week. Our Local Choice CSK Memberships last 4 months. When you renew your membership (by putting more money down) you renew your 4 month membership.
Seasonal Membership Our seasonal membership offers members an opportunity to prepay for a specified number of servings each week and we have your food ready for you every Wednesday. 3 month membership=12 weeks. Our Next Seasonal Memberships start in July and go until September. Each week you get 2 or 4 serving of: soup, vegetarian or meat entree (please specify), salad, side dish, and dessert.
Non-Profit or Business Membership We can create custom packages to meet your needs. Contact us to talk about how your business or non-profit can get delicious local food for meetings and other events and can help to support our local foods economy, local farms and our local cooperative.
Community or Neighborhood Membership We love to see food bringing people together. You can sign up other people in your neighborhood, business, church or community and either have one person pick-up each week and brings the food back to an accessible location or we will deliver it for you. This is a great way to know people and work together. Contact us for more details.
Gift Membership: I am redeeming a gift membership.
Other:

For the Local Choice Membership: How much money will you put down for a starting membership When you put down $100 or more you get an additional 10% credit

For our Seasonal Membership: How many servings per week do you want? When you put down $100 or more you get an additional 10% credit

2-3 Vegetarian Adult Serving $360 ($30 week),
2-3 Meat Servings a week $384 ($32 a week)
4-6 Adult Vegetarian Servings $660 ($55 a week),
4-6 Adult Meat Servings $708 ($59 a week)
Other:

Do you want to receive more information about:

Working Memberships
Volunteer Opportunities
Apprenticeships
Learning Opportunities & Classes

If you heard about us from a friend, who referred you?

Any questions or comments?