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.

Please make checks payable to "Congressman Jim Gerlach – Office Supply Account" and mail them to:
Office of Congressman Jim Gerlach
2442 Rayburn HOB
Washington, DC 20515

Please allow 4-6 weeks to process. We ask for your patience as, due to the high volume of requests, it often takes several weeks to process these requests.

If you have not received a reply to your email in this time, please contact my office at .

* 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 @ $14.30 each
3 X 5 Nylon @ $12.85 each
4 X 6 Nylon @ $18.55 each
5 X 8 Cotton @ $27.15 each
5 X 8 Nylon @ $23.05 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