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Please complete the form below, enclose your check, and mail to:
Honorable John W. Warner
United States Senate
Washington, D.C. 20510
Attention: Flag Coordinator
A PDF version of this form is availble here.
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All checks should be made payable to "KEEPER OF THE STATIONERY"
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An official certificate will accompany each flag. The following information is
required:
The flag will be presented to:
_________________________________________________
If recipient's home of record is not in Virginia, please contact his or
her Senator or Representative.
Date you wish flag flown over the Capitol:
_________________________________________
Occasion for which flag is being flown:
_________________________________________
Name of person presenting flag (If you wish this to be indicated on the
certificate):
_________________________________________
Your name/address/DAYTIME telephone
____________________________________________
____________________________________________
____________________________________________
Name/address flag is to be mailed:
____________________________________________
____________________________________________
____________________________________________
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PLEASE NOTE: Due to screening measures in place for all incoming Senate
mail, your flag request may face a delay of up to 3 weeks in reaching our office.
We are sorry for any inconvenience and appreciate your patience.
If you have any questions, please call our office at 202-224-2023.
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The sizes and fabrics are (please fill-in one):
| SIZE |
TYPE |
COST | QUANTITY | TOTAL |
| 3x5 |
Nylon |
$9.00 |
|
$ |
| 3x5 |
Cotton |
$9.25 |
|
$ |
| 5x8 |
Nylon |
$18.00 |
|
$ |
| 5x8 |
Cotton |
$20.00 |
|
$ |
Flying & Certification cost: $4.05 per flag
Shipping & Handling: $4.00 per flag
TOTAL $
Check or Money Order should be made payable to:
KEEPER OF THE STATIONERY
**Please allow 4 weeks after the fly date to receive the flag by mail and
3 weeks after the fly date for pickup.**
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