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U.S. Senator Ted Stevens
United States Senator, Alaska

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Constituent Services - Flag Requests

Flag Request Form

Required Information:

Date of Request:

Full Name

Street Address:

City:

State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

E-mail Address:

Optional Information:

Date flag to be flown:

Occasion:

Name of person flag is for:

Your Order

Size	Material	Unit Price	Qty
3' x 5'	Nylon	$9.00
3' x 5'	Cotton	$9.25
5' x 8'	Nylon	$18.00
5' x 8'	Cotton	$20.00
Flying and Certification*		$4.05
Shipping and Handling**		$4.00
		Total:	$0.00
* You must pay $4.05 per flag you wish to have flown. ** You must pay $4.00 per flag you wish to have shipped to you.