| Request by: _______________________________________________ |
| Phone# (w/ area code): ___________________ Date: __________ |
|
Mailing Instructions: Name: _________________________________________________ Address: ______________________________________________ City, State, Zip Code: ________________________________ |
| Would you like the flag(s) flown over the US Capitol Building? Yes____ No____ |
|
flown for... in recognition of... presented to... in memory of... in commemoration of... Person (if applicable): __________________________________ Occasion (if applicable): ________________________________ Date to be flown (if applicable): ________________________ |
*Please indicate below the amount and types of flag(s), the total cost and the final cost. If you want the flag flown over the US Capitol, and the flying fee to the flag price.
| FLAG SIZE | PRICE (shipping Included) |
FLYING FEE |
QUANTITY | TOTAL COST |
| 3 X 5 Cotton | $13.20 | $4.05 | ||
| 3 X 5 Nylon | $12.95 | $4.05 | ||
| 4 X 6 Nylon | $17.45 | $4.05 | ||
| 5 X 8 Cotton | $23.95 | $4.05 | ||
| 5 X 8 Nylon | $21.95 | $4.05 | ||
| *Total Cost=Price X Quantity *Final Cost=Sum of Total Cost |
Final Cost: | |||