2010 Rolling Prairie Membership Form

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Please read the following. If you agree, use the Print command on your browser to print the form, then fill in the information. New subscribers pay a $85 deposit and receive a copy of our Rolling Prairie cookbook. Previous subscribers pay a deposit of $75.  Mail the completed form with your deposit check made out to Rolling Prairie to the Site Coordinator for the site where you choose to pick up your bag.

I have read the information on the Rolling Prairie web page and understand that I am responsible for picking up my bag each week. I understand the price of each weekly bag is $17 or $14 for the economy bag at Local Burger (including sales tax) and that I will be billed monthly with payment due on the first pickup each month. I also understand that my membership is not activated until the site coordinator receives my deposit check. I understand that the equivalent of three weeks' bags will be applied towards my last bill, with the remainder to cover a portion of the operating expenses of Rolling Prairie Farmers Alliance.

Name _______________________________ Which pick up site and day would you like to use? (Click here for details on sites & times.)
Address _______________________________ __________________________________________
City _______________________________
Are you a returning member?
Zip ____________ How did you hear about Rolling Prairie?  
Email Address _______________________________
For Lawrence Members- Would you like to participate in the Early Bag (Mid- April- 1st Regular Bag)?______

The Late Bag ( last reg. pickup- End of Nov)?_____
Home Phone _______________________________

Work Phone _______________________________ Comments or questions?

 

Site coordinator addresses:

Lawrence Mondays (regular bag): 4:00-6:30pm Bob Lominska, 1954 Union Rd, Lawrence, KS 66044
785- 842-5697, rlominska@wildblue.net
Lawrence Thursdays (economy bag): 4:00-6:00pm Paul Johnson, 3960 Ridge Dr., Perry KS 66073
785- 597-5858, pdjohnson@wildflower.net
JCCC Wednesdays
4:00-6:00pm		 Stu Shafer, 3213 Buck Creek Rd., Oskaloosa, KS 66066
 785- 691-5006, sandheron@rollingprairie.net
Roeland Park CC, Wednesdays 4:30-6:30pm
Roeland Park Community Center,
Wednesdays 4:30-6:30 pm
The old Franklin site( aka Heart of America) has moved to the Roeland Park Community Center,4850 Rosewood
Drive in Roeland Park KS.

 Paul Conway, 25476 183rd St., Leavenworth, KS 66048
913-727-6121, pconway@wildblue.net

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