Fresh Food Box Please complete the form below to register for your Fresh Food Box. Payment can be processed over the phone or at the PCA hall during regular business hours. Fresh Food Box at Parkdale Farmer's Market Pre-order Monthly - weekly pickup Thursdays 3-7 PM. PLEASE NOTE: If you would like to receive more than one order per month, please enter the quantity below and include your pickup dates in the notes field. Step 1 of 2 50% Enter the date you wish to begin your order.* I would like to receive my order every ____ weeks.*1234Your total order will be charged on a monthly basis, based on the number of weeks you wish to receive the Fresh Food Box. Please ensure you add a sufficient quantity of boxes in the field below for your monthly order - for instance, if you want to receive a box every two weeks in a four-week month, you need to add "2" to the quantity for your chosen box. Large Organic Box - $45/week8 - 11 different produce items per box (assorted quantities). Mix of certified & non-certified spray-free organic veggies and fruit Price: $ 45.00 CAD Quantity: Small Organic Box - $35/week7 - 8 different produce items per box (assorted quantities). Mix of certified & non-certified spray-free organic veggies and fruit Price: $ 35.00 CAD Quantity: Large Box - $35/week10 - 13 different produce items per box (assorted quantities). Mix of veggies and fruit Price: $ 35.00 CAD Quantity: Small Box - $25/week7 - 8 different produce items per box (assorted quantities). Mix of veggies and fruit Price: $ 25.00 CAD Quantity: GST* Price: $ 0.00 CAD Total $ 0.00 CAD Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* This iframe contains the logic required to handle AJAX powered Gravity Forms.