MEMBERSHIP APPLICATION

WHITE ROSE FARM, 2008

Name: _______________________________________________________________
 

Address: _____________________________________________________________
 

City: ________________________ State: ________ Zipcode: ___________________
 

Phone (Home): _________________ (Work): ______________
(Cell): ______________

E-mail Address: ________________________________________________________

Do you want free weekly e- updates about what is available at the farm?    Yes    No

( If you would like the newsletter by snail mail, please include $12.50)           $12.50

Please circle the appropriate membership:

Long-distance Friend          

Adult          15.00                 Family         30.00

Limited Membership

 Adult           30.00               Family         45.00

Basic Membership

 Adult         45.00                Family          60.00

Premium Membership

 Adult         75.00              Family         90.00

Small Group Membership                     100.00

(List names and addresses of members on separate page)

Please list the extras that you would like:

 Your very own garden plot (10’ X 15’) $25.00/season   25.00

 Use of a storage bin at the farm ($15.00/season )   15.00

TOTAL:           _____

Make check payable to White Rose Farm, 5009 Teeter Road, Taneytown, MD 21787

410-756-9303, www.whiterosefarm.com