Raw Milk Sign-Up FormIn an effort to best organize our customers, would you please complete the below form? Name * First Name Last Name Phone * (###) ### #### Location... * Which milk would you like? * Goat Milk Cow's Milk How often do you anticipate picking up milk? * Weekly Occasionally or Sporadically If weekly, how many gallons do you anticipate ordering a week? 1 2 3 4 More Than Four. Questions, Comments, or Concerns? Legal Stuff! * This product, sold for personal use and not for resale, is fresh whole milk that has NOT been pasteurized. Neither this farm nor the milk sold by this farm has been inspected by the State of Arkansas. The consumer assumes all liability for health issues that may result from the consumption of this product. I Agree I Do Not Agree Thank you! We will be in touch with you soon!