BriarPatch Food Co-op | Fresh — Local — Organic in Grass Valley, CA

Owner Info Update

Hey BriarPatch Owners! Update your contact info and win a $100 gift card!

We need current information so we can send you a Board of Directors voting ballot, status about the store during storms or power outages, AND fun promotions! Send us updated information by midnight on March 20th and you’ll be entered into a drawing to win a gift card. We’ll draw for 3 cards – a $25, $50 and $100 card!

(Hey there! A mean little tech gnome is enjoying hijinks with this form. If you’re having trouble with filling out the fields or other strange things are happening, please email all of your information to Owner Relationship Coordinator Chelle Wheatley at ownership@briarpatch.coop. We hope to find that gnome soon send him packing!)

Primary Owner Name(Required)

First Last

Owner Number(Required)

Current Mailing Address

Street Address Address Line 2 City State ZIP Code

Current Email

Cell Phone Number

Additional Household Members

Household Member #1 Name

Lives at Address Above?

Yes

Household Member #2 Name

Lives at Address Above?

Yes

Household Member #3 Name

Lives at Address Above?

Yes

Other Additional Household Members and/or comments

Text Opt-In

Please send Office Owner Notices and information, Promotions and other fun stuff!

eReceipt Opt-In

Please send me electronic copies of my receipts.

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Name

This field is for validation purposes and should be left unchanged.