LexFarm · LexFarm Membership by Credit Card

LexFarm Membership by Credit Card

Contact Information

Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Email

*

Verify Email

*

Phone

*

Membership Information

Is this a New LexFarm Membership or a Renewal?

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New

Renewal

Membership Level

Please note that a Basic Household membership is required to purchase a CSA share and for discounts on LexFarm education programs.

I would like the following Basic Membership

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$25 - Basic Individual

$45 - Basic Household (minimum for CSA and Ed Program discounts)

I would like to upgrade my membership with an additional donation of:

$55 - Gardener (Total = $100)

$205 - Seeder ( Total = $250)

$455 - Grower (Total = $500)

$955 - Cultivator (Total = $1,000)

$4,955 - Steward (Total = $5,000)

$

Additional Household Member

Household memberships and higher can be shared with a Spouse/Partner in the same household. Please note that this is for donation tracking purposes only.

Would you like to enter contact information for a Spouse/Partner in the same household?

*

Yes

No

Name of Spouse/Partner:

First Name

Last Name

Spouse/Partner Email

Verify Email

Spouse/Partner phone