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.

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 .

* 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 @ $16.30 each

3 X 5 Nylon @ $16.05 each

4 X 6 Nylon @ $20.55 each

5 X 8 Cotton @ $27.05 each

5 X 8 Nylon @ $25.05 each

Do you want the flag flown over the Capitol? ($0) YesNo

Do you have a date preference? YesNo

If yes, please fill in date (allow 4-6 weeks notice prior to desired date) in mm/dd/yyyy:

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

Cynthia Lummis

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