U.S. Flag Request Form
This service is limited to constituents of Oklahoma’s Fourth Congressional District


STEP #1:         Your Name: ______________________________________________

                            Your Daytime Phone #: (________)_______________________

      Your Evening Phone #: (________)_______________________

PLEASE CHOOSE ONE OF THE FOLLOWING:

_______I wish to purchase a flag(s), but I do not wish for the flag(s) to be flown over the Capitol
(no Flag Fee will be charged and you should skip to "Address where flag is to be mailed")

OR

_______ I wish to purchase a flag, and I wish for the flag to be flown over the Capitol as follows:

            Name of person for whom the flag is to be flown: (Please print the name the way it should appear on the certificate.)

                            ________________________________________________________________

            Requested date to be flown** :____________________Flying Fee: $4.05 each

            On the occasion of: (Please print the occasion as it should appear on the certificate.)

            ______________________________________________________________________


NAME AND ADDRESS WHERE FLAG IS TO BE MAILED:

            _____________________________________________________

            _____________________________________________________

            _____________________________________________________


STEP #2: INDICATE QUANTITY for each FLAG SIZE/MATERIAL:

Quantity ordered Size of Flag Price as of 10/05 Your Subtotal ($)
  3x5 Cotton $9.25 each  
  3x5 Nylon $9.00 each  
  4x6 Nylon $13.50 each  
  5x8 Cotton $20.00 each  
  5x8 Nylon $18.00 each  

(continued)

STEP #3: DETERMINE MAILING ZONE:

Zone 5 -- Zip Codes begin with 743 and 744
Zone 6 -- Zip Codes begin with 730, 731, 734, 735, and 748

 Flag
Zone 5
Zone 6
Postage
Postage
3 x 5 Cotton
$4.90
$5.05
3 x 5 Nylon
$3.85
$3.85
4 x 6 Nylon
$4.90
$5.05
5 x 8 Cotton
$6.85
$7.15
5 x 8 Nylon
$4.90
$5.05

If you need the price of a combined shipping total for multiple flags,
please call our office for the exact shipping amount. If you wish to have the
flags sent separately, use the respective shipping amounts in the table for each flag.

STEP #4: ADD ALL FLAG FEE(s), PURCHASE COST OF FLAG(s), AND MAILING POSTAGE(s) TOGETHER:

Total Flag Fee(s): $________________

Total Purchase of Flag(s): $________________

Total Postage(s): $________________

OVERALL TOTAL reflected on Enclosed Check: $__________________


MAKE YOUR CHECK PAYABLE TO:
CONGRESSMAN TOM COLE OFFICE SUPPLY ACCT.

Mail the completed form with your check to:   The Honorable Tom Cole
                                                                   236 Cannon House Office Bldg.
                                                                   Washington, D.C. 20515
                                                                   ATTN: Liz Eddy

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
** Please be aware that the House generally requires at least 3 business days notice to request the flag be flown, and will take at least 5 business days to process shipment of a flag once it has been flown. Therefore, if you need the flag by a particular date, please take this into account and make sure that you place your order well in advance of when you anticipate delivery.
Also, please be advised that due to heightened mail security measures your letter may take up to 3 to 4 weeks to reach our office.

I regret that Flag Requests with checks that are not properly made out to the correct office Account or $ amount cannot be submitted to the House and will have to be returned to the sender, and may result in missing your requested flag flying date.

To ensure that you receive your flag in a timely manner, please feel free to call Liz Eddy in my Washington, D.C. office before mailing your request to verify that you have completed the form and payment correctly. Liz can be reached at (202) 225-6165.

If you are not a constituent of the 4th District, I regret that House Rules prohibit me from obtaining a U.S. flag on your behalf and all orders from non-constituents will be returned via U.S. mail with their checks.