Flag Request Form
| Print this form and mail it to the address below. | |
| Your Name: | ________________________________________ |
| Address: | ________________________________________ |
| Daytime Phone Number: | ________________________________________ |
| Address To Send Flag To: | ________________________________________ |
| Please Note: We are unable to ship to PO Boxes, please give street address only. | |
| Number/type of flags desired: | |
| 3' x 5' nylon . . . . . $ 9.00 | ____________ |
| 3' x 5' cotton . . . .. $ 9.25 | ____________ |
| 4' x 6' nylon . . . . . $ 13.50 | ____________ |
| 5' x 8' nylon . . . . . $18.00 | ____________ |
| 5' x 8' cotton . . . .. $20.00 | ____________ |
| Flying Certification Cost . . . . $4.05 per flag | ____________ |
| (If you want flag flown over U.S. Capitol) | |
| Shipping and Handling Cost. . . $ 4.00 per flag | ____________ |
| Total Cost..........$ | ____________ |
| Check Number | ____________ |
| (Please make checks or money orders payable to the "Keeper of the Stationery.") |
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| Name of Person for whom it is to be Flown: | ________________________________________ |
| Special Occasion/Event Flag is to be Flown: | ________________________________________ |
| Date you want Flag to be Flown: | ________________________________________ |
| The prices for flags and flag certification are subject to change per the request of the Keeper of the Stationery. | |
Mail this form, along with a check made out to "Keeper of the Stationery", to: Attn: Zack Smith |
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