Winter Apothecary CSA Sign-up!
Herbal Underground Apothecary CSA Member Info
Sign in to Google to save your progress. Learn more
Member Name (first & last) *
Address *
Phone # *
Email *
Cash, check, Venmo & PayPal (friends & family option) all work for payment. Please list your preferred payment option and (if applicable) list your Venmo/PayPal handle. *
How will you acquire your share? *
Please list a few other places - near work, school, etc. -  that would be convenient for pick-up! (pick-up members only)
If I could choose a dreamy herbal product to use every day it would be...
It there any additional information you'd like to share with Herbal Underground?
We're curious, how'd you find us??
In buying into this super fun Apothecary CSA I fully understand: *
Required
I have read and acknowledged the above statements. (please sign full name) *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy