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Home   /   Forms / Flag Request


 
You may e-mail me by filling out your information and comments below. Otherwise, please call, fax, or write your request to me.

Marietta District Office 219 Roswell St. Marietta, Georgia 30060 770-429-1776 (phone) 770-795-9551 (fax) Washington DC Office 119 Cannon House Office Building Washington, DC 20515 202-225-2931 (phone) 202-225-2944 (fax)

All email inquiries will receive a reply by mail in 10 business days.  
If you have not received a reply to your email in this time,
please contact my office at, 202-225-2931.

* First Name
* Last Name
* Address
* City
* State
* Zip Code
Phone Number
* Email Address

Indicate the number of which flag(s) you would like below:
Please note: flag prices are subject to change.

3 X 5 Cotton @ $12.25 each
3 X 5 Nylon @ $12.00 each
4 X 6 Nylon @ $16.50 each
5 X 8 Cotton @ $23.00 each
5 X 8 Nylon @ $21.00 each
Do you want the flag flown over the Capitol? ($4.05)
Do you have a date preference?

If yes, please fill in date (allow 4-6 weeks notice prior to desired date):
 
 
What occasion or person will this flag be for,
as you would like written on the certificate?
 Message
 
Send Flag(s) to (if other than listed above):
Name
Street Address
City
State
Zip
Phone