2019 Palmyra Produce for PantiesThis is the registration for for Palmyra families only.Name* First Last Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email*By giving us your email, you have opted in by giving us your e-mail address for the Produce for Pantries program. This is how we will contact you and will be sending the Produce for Pantries newsletters out to you. Product Name* New GardenerNew Gardeners will receive the following: Bed, Dirt, and SeedsReturning Gardeners only receive seedsPurchase Additional Beds*If you would like to have an additional bed, You may purchase them here. No Additional Bed(s) 1 Additional Bed ($51.65) 2 Additional Beds ($103.31) 3 Additional Beds ($154.96)Shipping* Pick up (At a location to be determined in Palmyra)Total $0.00 NameThis field is for validation purposes and should be left unchanged.
