Update Club Card Information

Please complete and submit the form below. This form is only for changes to an existing Dominick's Club Card account. Applications for NEW members can be downloaded here and must be submitted at your local Dominick's store

Replacement Cards can be obtained by visiting your local Dominick's store.

Update (check all that apply) *Required Fields

* Current Club Card #:

Old Club Card Information

	Title:

*	First Name:

*	Last Name:

	Street Address:

	City:


	State:

	Zip Code:

	Birthdate:

*	Home Phone:	( ) -

	E-Mail Address:

Your Store Location

Please provide the following information for your local store. For assistance on store information, please refer to the Store Locator.

	Street:

	Cross Street:

	City:


	State:

	Zip Code:

	Company Name:

New Club Card Information

Title:

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Birthdate:

Home Phone:

( ) -

E-Mail Address:

For Fast Forward Members Only (May not be available in all areas at this time)

10 Digit Cardless Number:

13 Digit Fast Forward Cross Reference Number:

Safeway Club Card Customer
Agreement Statement
We respect your privacy. Safeway does not sell or lease personally identifying information (i.e., your name, address, telephone number, and bank and credit card account numbers) to nonaffiliated companies or entities. We do record information regarding the purchases made with your SafewayClub Card to help us provide you with special offers and other information. Safeway also may use this information to provide you with personally tailored coupons, offers or other information that may be provided to Safeway by other companies. If you do not wish to receive personally tailored coupons, offers or other information, please check the box below. Must be at least 18 years of age.

Check this box only if you DO NOT wish to receive personally tailored coupons or offers from Safeway. By checking this box, you will not be eligible to receive any special offers for which you might otherwise qualify for through your use of your Safeway Club Card.

View Privacy Statement

Please DO NOT include your social security number, bank account number, or credit card number when corresponding with us using this page.