Flag Requests

* indicates required information.

Your Information

Purchaser’s name:*

Street address:*

Address, line 2:

City:*

State:*

ZIP:*

Phone number:* (for questions regarding your order)

Click the following checkbox to copy the purchaser's information into the fields below.

Shipping Address

The next address is where the order will be sent. This information must be filled in.

Ship To (Person's name):*

Street address:*

Address, line 2:

City:*

State:*

ZIP*:

Phone number (for questions regarding delivery problems)

Number of Flags

If you choose to have your flag flown over the United States Capitol, please complete the following information for the certificate. If you are ordering multiple flags to be flown on different dates or with different names and/or occasions to appear on each certificate, please leave the following fields blank and use a separate document to include that information.

Flag will be presented to: (name as it should appear on the certificate)

Special occasion:

Requested date for flag to be flown:

Please submit your request at least five weeks ahead of your desired date.