Please complete and print the form below. Then mail it along with your membership fee to:

Waltham Fields Community Farm
240 Beaver Street, Waltham, MA 02452

$25 Annual Dues

$ Donation Beyond Dues

$ Total Enclosed

Please make check out to Waltham Fields Community Farm. Please fill out the following contact information. Be sure to provide a current email address, as that is a primary way that we communicate with our members. We will not share any of your information.

Name

Address

City, State, Zip

Phone Number

E-mail Address

How did you hear about Waltham Fields Community Farm?

I wish my donation to remain anonymous.

Please print and mail this form and your check to us at Waltham Fields Community Farm, 240 Beaver Street, Waltham, MA 02452. You will receive a membership confirmation and a tax receipt for your contribution. Thank you!