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Purchase a Gift Certificate for Fall 2010 CSA

Instructions:

1) Complete the application below. The person receiving the certificate will have to complete the standard application, so the opportunity to make changes is always available.

2) When you click on 'Submit', your payment options will be available. You may use Visa, Master Card, Discover, or mail a check to Ambrose Family Farm, 2414 Rockland Ave., Wadmalaw Island, SC 29487.

3) After your payment has been made, please WRITE DOWN YOUR APPROVAL NUMBER. It will be the number we identify the certificate by and you will need to write it on the Gift Certificate.

4) Print a copy of the Gift Certificate, CSA Trifold Brochure, and Members Handbook. Use these as your gift.

5) Make sure the person you are gifting knows they must complete the standard application online. The web address is on the certificate.

The Following Information is about the person Giving the Gift Certificate
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Home Phone*
The following information is about the person RECEIVING the Certificate:
First and Last Name as you will pirnt it on the Certificate:*
Street:*
City and Zip Code*
Share Size*
Small
Medium
Large
Extra Large
If you know the receiver's email address, please list it here.
Please list the receiver's primary phone number here

Please enter the word that you see below.