Organic Food ClubMembership Application Name * First Name Last Name Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Occupation Hobbies and Skills Phone (###) ### #### Member Type Annual ($10/year) Concierge ($120/year) Lifetime ($500) What is your food philosophy? e.g. Omnivore, Vegetarian, Vegan, Plant-Based Raw Foodist, etc. What percentage of your diet is organic? Would you like to learn more about organic lifestyle choices? Yes No Would you like to volunteer on the farm? Yes No Would you be interested in joining the Organic Food Buying Club to get other organic products and groceries? Yes No Thank you! Organic Food Club7301 North Cicero Avenue, Lincolnwood, Illinois 60712847-561-1302
