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NAME: ___________________________________________
ADDRESS:
________________________________________
_________________________________________________
CITY:
_________________ STATE: ______ ZIP:
_______
REQUEST
CONTACT NAME AND PHONE NUMBER:
___________________________________
If
flag is to be flown over the Capitol, fill in the following
information for use on the flag certificate:
Date
you would like your flag flown over the Capitol: __________
(If date is specified, order should be received four
weeks prior
to the date on which flag is to be flown.)
Person(s)
or organization(s) for whom the flag
will be flown: ___________________________
Occasion
(if any): _____________________________________
The
prices of the flags are as follows:
| Size
|
Quantity
|
Type
|
Total
|
|
3' x 5' |
x $9.00 |
Nylon Flag |
$ |
|
3' x 5' |
x $9.25 |
Cotton Flag |
.
|
|
5' x 8' |
x $18.00 |
Nylon Flag |
.
|
|
5' x 8' |
x $20.00 |
Cotton Flag |
.
|
|
Flying & Certification Cost |
x $4.05/flag |
.
|
.
|
|
Shipping & Handling |
x $4.00/flag |
.
|
.
|
|
Order Total |
$ |
Please make your check or money order payable to "Keeper
of the Stationery" and return with completed form
to the following address:
Senator
Dianne Feinstein
ATTN: Flag Request
331 Hart Senate Office Building
Washington, DC 20510-0504
Due
to the high volume of requests, please allow 8-10 weeks
for processing and delivery.
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