Flag Request Form

Our office is honored to provide our constituents the opportunity to obtain an American flag which has been flown over the U.S. Capitol and a certificate of authenticity. Requests cannot be processed more than one month prior of the date the flag would need to be flown. When ordering, please allow for 4-6 weeks from the date the flag is flown over the Capitol to the date of receipt. Be advised that the flag office is not taking rush orders at this time. Also please be aware that flags are flown on an as-needed basis, and cannot be flown for dates that have already passed. Take advantage of our online ordering system and fill out the flag request form below.

Congresswoman Virginia Foxx
Attn: Flag Request
6000 Meadowbrook Mall, Suite 3
Clemmons, NC 27012

Make checks payable to:
Rep. Virginia Foxx Office Supply Account

* indicates required information.

Your Name:
Prefix First Name * MI Last Name * Suffix (Jr., Sr.)
* Your Address:
* City: State: Zip:
Phone Number:
* Email:
Recipient's Name:
Prefix * First Name * MI Last Name * Suffix (Jr., Sr.)
* Shipping Address:
* City: State: Zip:

Size Fabric Quantity Flown
over the Capitol		 Quantity NOT Flown
over the Capitol		 TOTAL
3'x5' Nylon @ $13.05 @ $9.00
3'x5' Cotton @ $13.30 @ $9.25
4'x6' Nylon @ $17.55 @ $13.50
5'x8' Nylon @ $22.05 @ $18.00
5'x8' Cotton @ $24.05 @ $20.00
Subtotal
S & H
TOTAL

Date to be Flown: (at least three weeks from now)

Required certificate text:
This is to certify that the accompanying flag was flown over the United States Capitol on [date] in honor of...
* Continue Message: