Share your opinion and be rewarded! North Farm Cooperative Updated Information

OFFICE USE:

  rec'd: _____________
  by: _______________
If contact people/addresses/phone numbers have changed, fill out this sheet and send it back to North Farm.
Customer Name: __________________________________________  Customer Number: _______________

Mailing Address: __________________________________________________________________________
                         
________________________________________________________________________________________
Street or Rural Route
________________________________________________________________________________________
City                                                                State                          Zip

E-mail Address: ___________________________________

Drivers need updated contact information in case of bad weather, breakdowns or delays.
CONTACTS: Name: Daytime Phone #
Coordinator/President _____________________________________ ______________________
Order Placer/Buyer _____________________________________ ______________________
Bookkeeper _____________________________________ ______________________
Delivery Contact _____________________________________ ______________________
2nd Delivery Contact _____________________________________ ______________________
IMPORTANT:
Delivery Site Phone #		 _____________________________________ ______________________

How often do you order from North Farm? _________________________________________________________
May we give out your phone number to possible new customers or inquiries?  YES  NO
Name: _____________________________________  Daytime Phone: ____________________
______________________       _____________________________________________________
Date                                       Signature
Please send this form to: Account Changes
North Farm Cooperative
204 Regas Road
Madison, WI  53714

Fax: 608-241-0688 u Toll-Free Fax 888-632-3276