The American flag has long been a powerful symbol of our nation’s unity and democratic ideals. Americans have shared this symbol through times of national triumph and national struggle, war and peace, life and death.

Senator Bayh’s office, through the United States Senate, makes available American flags for purchase that have been flown over the U.S. Capitol. Also available are flags that have not been flown over the Capitol.

Presenting a flown flag is found by many to be a patriotic way of honoring an individual or organization. If you choose to purchase a flag flown over the Capitol, it will be accompanied by a certificate showing when it was flown and for what occasion.

To Order a flag, please fill out the following order form.  Make your check or money order payable to "Keeper of the Stationery" for the total amount.

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Qty.	Size	Material	Price	Flown over Capitol	Sub-total
	3' x 5'	Cotton	$9.25	Yes ($4.05/flag)
	3' x 5'	Nylon	$9.00	Yes ($4.05/flag)
	5' x 8'	Cotton	$20.00	Yes ($4.05/flag)
	5' x 8'	Nylon	$18.00	Yes ($4.05/flag)
Shipping & Handling ($4.00 per Flag)			$0.00
Total					$0

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In Honor of

Salutation	-- Mr. Mrs. Ms. Miss Mr. and Mrs. Dr. Prof. Senator Gov. Congressman Hon. Fr. Sister Rabbi Reverend Admiral Commander Colonel General Lieutenant Lt. Col. LCDR Major Private Sergeant Petty Officer
First Name
Last Name
Occasion
To Be Flown On	Any Date Specific Date
Select Date	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010
Special Instructions

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Requester's Contact Info

First Name *
Last Name *
Phone Number *
E-mail *
Verify E-mail *

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Requestor's Address

Street Address *
Street Address (2)
City *
State *	-- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip Code *

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Shipping Address

	Shipping address is the same as requestor's address
Street Address *
Street Address (2)
City *
State *	-- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip Code *

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Payment Information

Note: This form cannot process transactions, after clicking the submit button you will be able to print off your completed form. Please mail this form with payment to:

Flag Coordinator
c/o Senator Evan Bayh
131 Russell Office Building
Washington IN 20510

Check

Money Order

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