"Are You The One?" Sweepstakes Entry Form

 NO PURCHASE NECESSARY. ONE ENTRY PER PERSON.

Entrant must: A) be at least 21 years old and be a legal resident of California,
B) have a permanent residence in Southern California (in zip codes 90000-93599)
at the address listed on the entry form within (3) months prior to the start of
the Sweepstakes; C) complete the entire Sweepstakes entry form (on-line, in person
at a participating Farmers agency or at the Long Beach BMW dealership in
Signal Hill, California, prior to the scheduled game day); and D) be present to
claim the Prize at the Angel City Classic 2008 Football Game on the scheduled game day.
A random drawing of all Sweepstakes entry forms received will be made for
one (1) winner of the Prize ("Prize Winner" or "Winner").

Entrant's submission of an entry in this Sweepstakes
constitutes acceptance of these Official Rules.

Do NOT use commas in your entry. * Required fields

*First Name: 
*Last Name: 
*Address 1: 
Address 2: 
*City: 
*State: 
*Zip Code: 
*Phone:  () -
*E-mail: 
*Confirm E-mail: 
*How did you learn about the
Farmers & BMW car promotion? 
*Do you own your own home?  Yes No
Homeowners/renters insurance company name: 
*Do you own an automobile?  Yes No
What model? 
Automobile insurance company name: 
*Do you plan to purchase a car in:  30 days 60 days 90 days
6 - 12 months 1 year or more
*I am interested in more information about: 
  Farmers and/or Long Beach BMW may contact
me about other products and services.