FLAG ORDER FORM

Send check or money order to:	Congressman Dave Reichert

Attn: Flag Order

2737 78th Ave SE, Suite 202

Mercer Island, WA 98040

Flying Instructions

Certificates will be printed exactly as information is given below.

1) Is the flag to be flown over the Capitol? Yes	No (Please skip to Section C)
2) To be flown in

Memory of:

Honor of:
3) On the occasion of:
4) Date to be flown: ASAP
5) Date needed (if urgent):
The flag request cannot be processed until our office has received payment in addition to this order form via fax or email. Please allow 4 – 6 weeks for flag orders to be processed.

Shipping Address:

Name	Street Address
City/State/Zip

Your address (if different from above):

Name	Street Address
City/State/Zip
Phone ( )	Email

Please indicate quantity and which size and type of flag you would like to order:

Flag Type	Quantity
3x5 Nylon
3x5 Cotton
4x6 Nylon
5x8 Cotton
5x8 Nylon
TOTAL

Please use the E-Flag Calculator to compute your total invoice.

Checks must be: a) Payable to the “Office Supply Service Account of Dave Reichert,” b) Written for the exact amount; c) Dated on or around the flying date.

Congressman Dave Reichert

Serving the 8th District of Washington

mreffett

2007-07-03

ashilling

U.S. House of Representatives