Flag Request Form

** Please note that we are unable to accommodate requests for flags to be flown over the Capitol after November 1, 2012. To request a flag, I encourage you to contact California’s U. S. Senators Dianne Feinstein or Barbara Boxer. Links to their websites are listed below. **

Senator Feinstein
Senator Boxer

If you live in the 6th Congressional District, my office can assist you in obtaining an American flag that has flown over the United States Capitol. Each flag comes with a certificate that includes the date it was flown over the Capitol and the occasion for which the flag was flown. Print out and send this form, along with a check made out to Office Supply Account CA0631, to my Washington, DC office.

The Honorable Lynn Woolsey
Attn: Flag Coordinator
2263 Rayburn House Office Building
Washington, DC 20515

Make checks payable to:
Office Supply Account CA0631

Please allow six to eight weeks for the flag to be flown and delivered.

** If you need the flag within the next two weeks, please call rather than send the form -- (202) 225-5161 **

* indicates required information.

Your Information

Prefix: Select One Mr. Mrs. Miss. Ms. Dr.

First Name:*

Middle Initial:

Last Name:*

Suffix:

Street address:*

Address, line 2:

City:*

State:* California Alaska Alabama Arkansas Arizona Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York North Carolina Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington DC Washington Wisconsin West Virginia Wyoming

ZIP:* +4

Phone number:* (for questions regarding your order)

E-mail Address:*

Click the following checkbox to copy the purchaser's information into the fields below.

Shipping Address

The next address is where the order will be sent. This information must be filled in.

Prefix: Select One Mr. Mrs. Miss. Ms. Dr.

First Name:*

Middle Initial:

Last Name:*

Suffix:

Street address:*

Address, line 2:

City:*

State:* California Alaska Alabama Arkansas Arizona Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York North Carolina Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington DC Washington Wisconsin West Virginia Wyoming

ZIP*: -

Phone number (for questions regarding delivery problems)

Number of Flags Price includes shipping

* "Eco-Glory" premium recycled flag is made from recycled plastic, woven and dyed into red, white and blue material; flags have sewn stripes and embroidered stars; shipped complete in a recycled cardboard box.

If you choose to have your flag flown over the United States Capitol, please complete the following information for the certificate. If you have multiple flags to fly, they must all be flown on the same date. If you have multiple flags to fly on the same date, and you would like different names and/or occasions to appear on each certificate, please leave the name and occasion information below blank, and use a separate document to enclose that information.

Care of the Flag

Most outdoor flags can be washed in mild detergent and thoroughly rinsed. Indoor and parade flags should be dry-cleaned. Damaged flags can be repaired and utilized as long as the overall dimensions are not noticeably altered. American Legion Posts and local governments often have facilities to dispose of unserviceable flags. Store your flag in a clean, well ventilated area.

Dedication Message

This flag was flown for on

Special Instructions for the Flag Coordinator

Please submit your request at least five weeks ahead of your desired date.