CSA Registration

Refugee Community Services

Your Name (required)

Phone Number

Your Email (required)

Your Address

What share would you like? (required)

$50 deposit is required to save your spot. Payment in full is due by May 10. (required)

How did you hear about us (required)

We will have three public pickup locations. Which of these sites would you prefer?
LSI Refugee Connection Center (3200 University Ave, Des Moines, IA 50311) from 3:30pm-6:00pm.Valley Community Center (4444 Fuller Rd, West Des Moines, IA 50265) from 4:00pm-6:00pm.Ankeny Lutheran Church of Hope (520 NW 36th St, Ankeny, IA 50023) from 4:00pm-6:00pm.Wellmark (1331 Grand Ave, Des Moines, IA 50309; only open to Wellmark employees) from 3:30pm-4:30pm.

I’d like to gift a CSA share to someone else?
Yes (LSI staff will be contacting you)No

Would you like to sign up for Delivery?
(please read delivery information above for prices and to see if you qualify for home delivery)
Yes (LSI staff will be contacting you)No

If you will be sharing or splitting your CSA share with a friend or family member, please list their contact information below.

Friend's Name

Friend's Phone Number

Friend's Email

Friend's Address

Additional Comments