JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Delivery Request
After you fill out this CSA delivery inquiry, we will notify you if your request have been approved. Our CSAs are limited in numbers and local delivery is available within 10 miles of the Kokomo to West Lafayette route on IN-26. Deliveries will be on Saturday following your scheduled subscription Friday pickups – bouquets will be left on your doorstep in water and under shade (if shade is available). More FAQs on our CSAs and delivery can be found at
https://www.pineandposey.com/services/csa/
. Contact us at
hello@pineandposey.com
if you have other questions!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Are you a new or existing CSA customer?
I am a new customer
I have already purchased a CSA but would like delivery added
Clear selection
Delivery Address
*
Please enter the street address, city, state and zip code.
Your answer
Is this a residential or business address?
residential
business
Preferred spot to leave
*
Let us know where you'd prefer your CSA to be left - ex. front doorstep, on the porch, under garage port, etc..
Your answer
Terms & Conditions
*
Please read our delivery terms and conditions.
I have read and agree to Pine & Posey's delivery terms and conditions.
Required
Contact info at delivery location:
Name
*
Your answer
Phone number
*
Your answer
E-mail
*
Your answer
Contact info for payment (if different than above):
If you are gifting a CSA to someone else, please add your information here and their contact info above.
Name
Your answer
Phone number
Your answer
E-mail
Your answer
Questions and comments
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pine & Posey LLC.
Report Abuse
Forms
