2025 Patelco Safeway Sweepstakes Form

Company

First Name*

Last Name*

Street Address*

City*

State* Must be resident of California to be eligible.

Zip Code*

Email Address*

Phone Number*

Date of Birth*

Must be 18 or older to be eligible.

Are you an existing member?*

Yes No

By submitting, you agree for Patelco to contact you regarding the drawing and to the official rules.