Federal & California Privacy Choices

After reviewing Patelco's Federal Privacy Notice and California Privacy Form, I want to choose the following:

	Do not share my personal information with other financial institutions to jointly market to me.
	Do not share information about my creditworthiness with your affiliates for their everyday marketing purposes.
	Do not allow your affiliates to use my personal information to market to me.
	Do not share personal and financial information with your affiliated companies. (applies to California residents only)

First Name *	First Name is required.
Last Name *	Last Name is required.
Member Number *	Member Number is required. Only Numbers allowed
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If you have multiple member numbers, please complete the above for each unique member number.